Home Screening for Bacterial Vaginosis to Prevent Sexually Transmitted Diseases

Clin Infect Dis. 2016 Mar 1;62(5):531-6. doi: 10.1093/cid/civ975. Epub 2015 Nov 26.


Background: Longitudinal studies have consistently found a significant association between bacterial vaginosis (BV) and acquisition of sexually transmitted diseases. However, there are limited prospective data to confirm these findings.

Methods: We conducted a prospective, randomized, open-label trial of home screening and treatment of young women with asymptomatic BV who were also at high risk for sexually transmitted diseases. These women were screened every 2 months for 12 months and randomized to treatment with oral metronidazole 500 mg twice daily for 7 days or observation alone. The primary outcome was the incidence of gonorrhea and/or chlamydia.

Results: A total of 1365 subjects were enrolled in the study across 10 sites. Adherence with mailing specimens obtained at home was excellent in both groups (84%-88%). The incidence of gonorrhea and/or chlamydia was 19.1 per 100 person-years (95% confidence interval, 15.1-22.1) for the treatment group and 18.5 per 100 person-years (15.1-22.8) for the observation arm, a difference that was not statistically significant.

Conclusions: Young women were very amenable to home screening for BV, gonorrhea, and chlamydia. Treatment of asymptomatic BV with 1 week of oral metronidazole did not decrease the incidence of gonorrhea and/or chlamydia.

Clinical trials registration: NCT00667368.

Keywords: STD; bacterial vaginosis; home screening.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / prevention & control
  • Diagnostic Self Evaluation*
  • Female
  • Gonorrhea / diagnosis*
  • Gonorrhea / epidemiology
  • Gonorrhea / prevention & control
  • Humans
  • Incidence
  • Mass Screening / methods*
  • Prevalence
  • Prospective Studies
  • Reagent Kits, Diagnostic
  • Vaginal Smears
  • Vaginosis, Bacterial / diagnosis*
  • Vaginosis, Bacterial / drug therapy
  • Vaginosis, Bacterial / epidemiology
  • Young Adult


  • Reagent Kits, Diagnostic

Associated data

  • ClinicalTrials.gov/NCT00667368