Nine hundred (79.3%) women in this analysis were African American and 235 (20.7%) were non-Hispanic white (Table 1). Many characteristics differed between black women and whites including that blacks were less likely to have any education past high school or family incomes >$20,000, to be current smokers, and to have more than one sexual partner or a new partner in the past two months. Black women were more likely to be 25 years or older, to have a history of a sexually transmitted disease including PID, to have been pregnant, and to have douched in the past two months. Frequent douching (>once per month) and recent douching (within zero to seven days) were also more common among black women.

BV (44.0%) was more common in black women than in white women (25%); similarly, BV/intermediate vaginal flora was more common in black women (69.0%) than in whites (46.6%, p<0.0001). The direction of the associations between risk factors and BV/intermediate vaginal flora generally tended to be the same among blacks and whites (Table 2). For both racial groups, significant associations to BV/intermediate vaginal flora were found for reduced income, a history of gonococcal cervicitis, a history of trichomoniasis, having a previous pregnancy, lack of hormonal contraceptive use, douching, and more frequent douching. Although the odds ratio for ever douching was stronger in white women (2.5, 95% CI 1.4-4.5) than in black women (1.3, 95% CI 1.0-1.8), a test for heterogeneity did not indicate that these odds ratios were significantly different. In race-specific multivariable models, among both black and white women, a history of trichomoniasis, lack of hormonal contraception, and more frequent douching remained important explanatory variables for BV/intermediate vaginal flora.
tadalis sx 20

Table 1. NUMBER (%) OF BLACK AND WHITE WOMEN WITH SELECTED BACTERIAL VAGINOSIS RISK FACTORS

In that several risk factors, including douching, were differentially distributed between racial groups, we constructed multivariate mod­els to discern the independence of the relationship between race and risk for these outcomes. After adjustment for all important sociodemo-graphic and lifestyle factors, and then simplification of logistic regression models, black race remained a strong, independent risk factor for BV/intermediate vaginal flora (OR 2.2, 95% CI 1.5-3.1) (Table 3). Black race also was independently related to specific vaginal microflora including lack of H₂0₂+ lactobacillus (OR 2.0, 95% CI 1.4-2.8); Gardnerella vaginalis (OR 1.9, 95% CI 1.4-2.6); Mycoplasma hominis (OR 2.1, 95% CI 1.5-3.1); anaerobic Gram negative rods pigmented (OR 2.0, 95% CI 1.4-2.8), and non-pigmented (OR 1.7, 95% CI 1.1-2.5); and Mobiluncus morphotypes (OR 4.5, 95% CI 2.4-8.4). Finally, blacks were more likely to have gonococcal or chlamydial cervicitis (OR 2.2, 95% CI 1.2-3.8).
buy antibiotics in canada

Table 2. UNADJUSTED ODDS RATIOS (ORS) FOR BACTERIAL VAGINOSIS/INTERMEDIATE VAGINAL FLORA BY RACE

We conducted a series of secondary analyses to test the robustness of our results. First, we separately considered women who did not have Mobiluncus morphotypes, since a previous analysis found that much of the link between race and BV might be accounted for by the bacterium. However, in women without Mobiluncus morphotypes, the relationship between black race and BV/intermediate flora remained significant (OR 1.7, 95% CI 1.2-2.4), as did the relationships between race and absence of H₂0₂+ lactobacilli, G. vaginalis, and anaerobic pigmented gram negative rods. canadian antibiotics

Table 3. MULTIVARIATE ADJUSTED* ODDS RATIOS FOR BV/INTERMEDIATE VAGINAL FLORA, SPECIFIC VAGINAL

(continue table 3) (ORS) FOR RACE AND OTHER RISK FACTORS MICROFLORA, AND GONOCOCCAL OR CHLAMYDIAL CERVICITIS

Second, we grouped together the intermediate vaginal flora (Nugent scores of 4-6) and normal flora categories, comparing these in combination to women with BV (Nugent scores of 7-10). This had virtually no effect on the adjusted association between race and BV (OR 2.2, 95% CI 1.53.1). Further model manipulations including entering clinical site as discrete, rather than a continuous variable, and including gonococcal/chlamydial cervicitis in the model also had virtually no effect on the relationship between race and BV.
tadacip 20 mg

Finally, we separately considered women with and without gonococcal or chlamydial cervicitis, so as to be able to compare our results with previous studies that either did or did not recruit from STD clinics. Among women with these sexually transmitted infections, the relationship between race and BV was attenuated (OR 1.5, 95% CI 0.4-4.9). However, among women without cervicitis, the relationship between black race and В V remained strong (OR 2.5, 95% CI 1.8-3.4). These results were little affected by adjustment for sociodemographic and lifestyle factors (Results not shown).