STI Classification: Bacterial Vaginosis Treatment Shift

Bacterial vaginosis, a condition affecting nearly one-third of women worldwide, is now considered a sexually-transmitted infection (STI) by researchers, who are calling for a "major paradigm shift" in treatment, including educating patients on the role of sexual transmission and engaging male partners in treatment.

A study published in the New England Journal of Medicine found that treating male partners alongside female patients significantly reduces the recurrence of bacterial vaginosis, which is commonly associated with infertility, premature births, and newborn deaths. The study, which involved 164 couples, found that treating both partners reduced BV recurrence by 50%, confirming that reinfection from male partners is a major cause of recurrence.

Current medical guidelines treat bacterial vaginosis as an imbalance in the vaginal microbiome rather than an STI, resulting in a high recurrence rate of over 50% within three months after treatment. However, the new findings suggest that a combination of oral and topical antibiotics for male partners can clear bacteria from both the penile skin and internal sites, leading to a significant reduction in recurrence rates.

Experts are urging clinicians to shift how they discuss bacterial vaginosis with patients, emphasizing the need to engage male partners in transmission and treatment. The Melbourne Sexual Health Centre has already changed its clinical practice, treating couples together, and other healthcare providers are expected to follow suit.

The reclassification of bacterial vaginosis as an STI and the new treatment approach have the potential to significantly improve the health outcomes of women affected by the condition, and experts hope that the findings will lead to a reduction in the incidence of adverse birth outcomes and other STIs associated with bacterial vaginosis.