Partner Treatment Trials
1Melbourne Sexual Health Centre, The Alfred Hospital, Victoria, Australia; 2Central Clinical School, Monash University, Melbourne, Victoria, Australia
Bacterial vaginosis is the most common vaginal dysbiosis with the highest burden of disease in women in low income countries and with poor access to healthcare1,2. Current recommended antimicrobial therapy achieves high level short-term cure but post-treatment recurrence exceeds 50% within 6 months3. This presentation will examine why have we made no significant inroads into improving BV cure, and the likely pathogenesis of post-treatment recurrence. Epidemiological studies suggest both reinfection and persistence play a role4. Data on sexual transmission of BV will be discussed and past male partner treatment trials. The rationale for new male partner treatment trials will be presented including discussion of interventions, feasibility, and acceptability5. Many of the difficulties that impacted on past male treatment trials6 are highly relevant and discussion will be encouraged about the logistical constraints faced by clinicians/researchers in undertaking such trials and ensuring successful recruitment and retention in a range of settings. Preliminary data from male partner treatment studies will be presented and discussion on the need for female partner treatment trials. Determining the contribution of reinfection to recurrence is important as if reinfection is a dominant factor in recurrence this will impact on our ability to assess the efficacy of strategies/therapies directed only to women. Time will be made available to discuss strategies and collaborative opportunities to determine how we make substantive progress with couple-specific interventions for BV.
1. Chico, RM et al. JAMA 307; 2079-2086, 2012
2. Allsworth, JE et al. Obstet Gynecol 109; 114-120, 2007
3. Bradshaw, CS et al. J Infect Dis 193; 1478-1489, 2006
4. Unemo M, Bradshaw CS, et al. Lancet Infect Dis 17(8):e235-e279, 2017
5. Plummer EL, et al. PLoS One. 13(1):e0190199, 2018.
6. Mehta, SD. Sex Transm Dis 39; 822-830, 2012
National Health and Medical Research Countil, Project Grant Project Grant APP1138165. Alfred Research Trust Seeding Grant 2016.