Study: BV, HIV and herpes – is all what it seems?

A study[1. Nagot N, Ouedraogo A, Defer M, Vallo R, Mayaud P, Van de Perre P. Association between bacterial vaginosis and Herpes simplex virus type‐2 infection: implications for HIV acquisition studies.Sexually Transmitted Infections. 2007;83(5):365-368. doi:10.1136/sti.2007.024794] into the link between herpes (herpes simplex 1 and herpes simplex 2) and bacterial vaginosis (BV) has been conducted.

The study relates to the incidence of HIV infection, since previously it has been put forward that HIV and BV go hand in hand, due to BV microbes creating an unfriendly environment for good bacteria, thus leaving the vagina exposed to invaders.

Take-homes from the study

HSV-2 (genital herpes) and BV appear to be linked. This link may be the same as the link for other sexually transmitted infections like HIV, with the increased risk likely due to a lack of vaginal protections from healthy microbes when the vagina is in a state of bacterial vaginosis.

The BV, HIV and herpes study details

The women researched are sex workers in Burkina Faso, a West African country. Women of African descent are known to have more BV than other women, due to normal variations in vaginal microflora. This means the population of women studied are already in a position to more often develop BV, plus extra sexual activity with multiple partners putting them at increased risk of contracting sexually transmitted infections such as herpes.

What this means is that we’re dealing with an extra susceptible group of women. The study followed 273 women, with three-monthly visits to diagnose genital infections and to report on sexual behaviours.

Study results

  • Women who had three or more sexual partners in the preceding week had more BV
  • Women who were on hormonal contraception saw a protective effect
  • HSV-2 was associated with BV in this population
  • BV incidence was not linked to HIV infection
  • HSV-2 status was independent of HIV status as it related to incidence of BV
  • BV could facilitate HSV-2 acquisition

The researchers explained that it’s possible that intermittent HSV-2 genital shedding could disrupt vaginal flora or be linked to hormonal changes (i.e. menstrual blood), which can both trigger episodes of BV. BV has previously been strongly associated with HSV-2 shedding episodes.

The consistent protection of hormonal contraception seems to be confirmed, though this could be because BV microbes favour an alkaline environment, provided by menstrual blood.  

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Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)