Submission ID 131979
| Issue/Objective | Bacterial vaginosis (BV), an imbalance of the vaginal microbiome, is highly prevalent (>50%) among adolescent girls and young women (AGYW) in South Africa, and can lead to long-term sexual and reproductive health consequences. Recent evidence for sexual transmissibility of BV highlights the need to understand how inequitable gendered power dynamics shape BV risk. We examined associations between measures of gender inequity and BV prevalence. |
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| Methodology/Approach | We analysed baseline data from AGYW enrolled in AYAZAZI, a youth-centered, community cohort study in South Africa (n=425, 16-24 yrs, n=253(60%) female). Interviewer-administered surveys collected data on demographics, sexual behaviour, relationship dynamics, and violence. BV was measured using Nugent scores derived from Gram-stains. Explanatory variables were measures of gender inequity, including experiences of sexual and physical/threatening intimate partner violence (IPV) (ever, within the last 6-months, or never), and age-disparate relationships (≥5-year age gap with primary partner). Multivariable logistic regression models analysed the associations between IPV, age-disparate relationships, and BV prevalence, and adjusted for income, education status, age, number of lifetime partners, condom use, and hormonal contraceptives. |
| Results | Of 253, 187 AGYW (73.9%) were included in this analysis. BV prevalence was 56.1%. Overall, 9.1% had ever experienced sexual IPV, 10.2% had ever experienced physical/threatening IPV, and 33.2% were in an age-disparate relationship. Among AGWY who had experienced sexual IPV ever or within the last 6-months, 38% (n=8) had BV. Among those who had experienced physical/threatening IPV ever or within the last 6-months, 51.5% (n=17) had BV. Two-thirds (67.7%, n=41) of AGYW in a relationship with a partner ≥5 years older had BV. Ever experiencing sexual or physical/threatening IPV were both associated with lower odds of BV (adjusted odds ratio (aOR)=0.31; 95%CI: 0.09, 0.92; p<0.05; and aOR=0.34, 95%CI: 0.10, 1.02; p>0.05, respectively), whereas age-disparate relationships were associated with higher odds of BV (aOR=1.61, 95%CI: 0.82, 3.24; p>0.05). |
| Discussion/Conclusion | Our study highlights that distinct aspects of IPV experiences or age-based power differentials shape variation in BV acquisition risk through different mechanistic pathways. Further understanding the role of gendered power inequities is critical for improving intervention strategies among AGYW who experience high rates of BV and gender inequities in South Africa. |
| Presenters and Affiliations | Amanda Rowlands Simon Fraser University Campion Zharima Perinatal HIV Research Unit (PHRU), & African Social Sciences Unit of Research and Evaluation (ASSURE), Faculty of Health Sciences, University of the Witwatersrand Mags Beksinska Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand Kalysha Closson Simon Fraser University Tatiana Pakhomova Simon Fraser University Smritee Dabee Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada Mzikazi Nduna Research Impact Division: Human Sciences Research Council, Julie Jesson Universite Toulouse, Inserm, CERPOP Thumbi Ndung'u Africa Health Research Institute Janan J. Dietrich Perinatal HIV Research Unit (PHRU), & African Social Sciences Unit of Research and Evaluation (ASSURE), Faculty of Health Sciences, University of the Witwatersrand Stefanie Vermaak Perinatal HIV Research Unit (PHRU), & African Social Sciences Unit of Research and Evaluation (ASSURE), Faculty of Health Sciences, University of the Witwatersrand Mark Brockman Simon Fraser University Angela Kaida Simon Fraser University |
