Bacterial Vaginosis Is Not an Independent Risk Factor for Human Papillomavirus Infection ID 1111

INTRODUCTION: Bacterial vaginosis (BV) is a prevalent vaginal condition associated with an imbalance in the vaginal microbiota. The relationship between vaginal dysbiosis and human papillomavirus (HPV) infection, a primary cause of cervical dysplasia and cancer, remains poorly understood. METHODS: A retrospective cohort study was performed, including all patients who presented to an academic medical center for cervical cancer screening between December 2020 and March 2022. Age-based cervical cancer screening was performed using cervical cytology with HPV co-testing when appropriate. Abnormal screening tests were managed by individual providers according to national guidelines. Testing for lower genital tract infections was performed if clinically indicated. Bivariate and multivariate logistic regression analyses were conducted to assess associations between BV status, clinical diagnosis of HPV infection, HPV persistence, and high-grade cervical dysplasia. RESULTS: A total of 4,793 patient visits were included. Black race, younger age, public insurance, smoking, current gonorrhea, chlamydia, trichomonas infection, and HIV infection were associated with clinical diagnosis of HPV infection. In the bivariate analysis, 62 of 397 (15.6%) of participants with BV had clinical diagnosis of HPV infection compared to 542 of 4,627 (11.7%) without BV ( P =.02). However, this association did not remain significant in the multivariable analysis. No significant associations were found between BV and persistent HPV or high-grade cervical dysplasia. CONCLUSIONS/IMPLICATIONS: While BV is associated with HPV infection, this association is strongly modified by social and behavioral factors. Bacterial vaginosis does not appear to be an independent risk factor for cervical HPV infection, persistence, or progression.