# Cumulative Lifetime Violence and Bacterial Vaginosis Infection in Sexually Transmitted Infections: Findings From a Retrospective Cohort Study Among Black Women at Risk for HIV

## TL;DR

Black women who experience cumulative violence are more likely to have bacterial vaginosis and sexually transmitted infections, highlighting the need for education and support.

## Contribution

This study identifies a significant link between cumulative violence exposure and increased odds of BV and STI diagnoses among Black women.

## Key findings

- Cumulative violence experience increases adjusted odds of lifetime BV diagnosis (AOR=1.98).
- BV diagnosis is strongly associated with increased odds of STI diagnosis (AOR=2.76 for lifetime BV).
- BV acts as a moderator linking cumulative violence to STI risk.

## Abstract

•Bacterial vaginosis (BV) and sexually transmitted infections (STI) are disparately prevalent among Black women.•Cumulative violence experience was significantly associated with increased adjusted odds of lifetime BV diagnosis.•Lifetime BV diagnosis and past-year BV diagnosis were significantly associated with increased odds of lifetime STI diagnosis. Lifetime BV diagnosis and past-year BV diagnosis were significantly associated with past-year STI diagnosis.•More education and support are needed for Black women who experience cumulative violence for BV to reduce the risk of untreated BV and STIs.

Bacterial vaginosis (BV) and sexually transmitted infections (STI) are disparately prevalent among Black women.

Cumulative violence experience was significantly associated with increased adjusted odds of lifetime BV diagnosis.

Lifetime BV diagnosis and past-year BV diagnosis were significantly associated with increased odds of lifetime STI diagnosis. Lifetime BV diagnosis and past-year BV diagnosis were significantly associated with past-year STI diagnosis.

More education and support are needed for Black women who experience cumulative violence for BV to reduce the risk of untreated BV and STIs.

Bacterial vaginosis is the most common vaginal condition among women of reproductive age and has been associated with sexually transmitted infections. This study examines the association between cumulative lifetime violence exposure, bacterial vaginosis, and sexually transmitted infections among Black women at risk for HIV.

HIV-negative Black women in a retrospective cohort study (N=230) completed survey questions on cumulative violence (exposure to sexual or physical abuse before age 18 years and exposure to intimate partner violence or sexual violence [partner or other] after age 18 years and past year), bacterial vaginosis (lifetime and past year), and sexually transmitted infection diagnosis (lifetime and past year). Logistic regression models estimated the associations between cumulative violence, bacterial vaginosis, and sexually transmitted infections. Bacterial vaginosis was examined as a moderator in the association between cumulative violence and sexually transmitted infections.

Many women reported cumulative violence exposure (40%), lifetime bacterial vaginosis diagnosis (53%), and lifetime sexually transmitted infection diagnosis (73%). Cumulative violence experience was significantly associated with increased adjusted odds of lifetime bacterial vaginosis diagnosis (AOR=1.98; 95% CI=1.10, 3.54). Lifetime bacterial vaginosis diagnosis (AOR=2.76; 95% CI=1.45, 5.22) and past-year bacterial vaginosis diagnosis (AOR=2.16; 95% CI=1.14, 4.10) were significantly associated with increased odds of lifetime sexually transmitted infection diagnosis. Lifetime bacterial vaginosis diagnosis (AOR=2.10; 95% CI=1.19, 3.70) and past-year bacterial vaginosis diagnosis (AOR=3.00; 95% CI=1.70, 5.31) were significantly associated with past-year sexually transmitted infection diagnosis. Lifetime bacterial vaginosis infection significantly increased the odds of lifetime sexually transmitted infection diagnosis with increasing cumulative violence exposure.

Our findings support educating and screening Black women who experience cumulative violence for bacterial vaginosis to reduce the risk of untreated bacterial vaginosis and sexually transmitted infections.