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Bacterial vaginosis (BV) is one of the most common genital infections among women of reproductive age [1, 2], yet its precise etiology and whether it is sexually transmitted are unknown.BV is characterized by a disturbance of normal vaginal flora, with a loss of H species and an increase in gram-variable coccobacilli, anerobic organisms, and genital mycoplasmas.We undertook a systematic review and meta-analysis of the published literature that investigated factors associated with BV, with the aim of evaluating the epidemiological evidence that may support or refute the hypothesis that BV is sexually transmitted.A Medline search of the published literature was conducted that covered the period from 1992 (when Medline introduced the search heading “bacterial vaginosis”) through November 2007.Publication bias was assessed by visual inspection of funnel plots that plotted the log of the effect size on the horizontal axis against the corresponding SE on the vertical axis.Open Epi software, version 2.2.1 [54], was used to recalculate ORs and 95% CIs, and Stata software, version 9 (Stata Corp), was used in creating the figures and performing the meta-analysis. Twenty-eight studies fulfilled the inclusion criteria and reported numbers of male sexual partners and/or a recent change of male sexual partner (figure 1).

Nine studies were cross-sectional studies, and 3 of these found a strong association between BV and having an increased number of female sexual partners (OR range, 2.2–3.5) [30–42].There was a positive association between a history of male sexual partners and the risk of BV, with an estimated relative risk for association of 1.6 (95% CI, 1.5–1.8).There was strong evidence against the null hypothesis of homogeneity of effect size of BV risk associated with a history of male sexual partners (P.Twelve studies reported data on sex with female partners in relation to BV and fulfilled the inclusion criteria (figure 2).One study was a cohort treatment study and found that BV recurrence was more likely if a woman reported having a female sexual partner after treatment (RR, 3.6; 95% CI, 1.5–8.5) [10].

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