Certain groups of minority women more susceptible to vaginal infections

A recent study has reported that women from non-Western countries are at increased risk of genital infections. Younger age also contributes to a risk increase, while living outside of larger cities seems to have a protective effect.

Conducted in Sweden, the study used nationwide primary healthcare data and included 2,357,711 women aged 15–50 years with a total follow-up of around 34 million person-years. Most women (74.6 percent) were from Sweden, 5.8 percent were from Eastern Europe, 4.7 percent were from Western countries, 7.1 percent were from the Middle East/North Africa, 2.4 percent were from other parts of Africa, 4.1 percent were from Asia, and 1.3 percent were from Latin America and the Caribbean.

During the follow-up, there were 109,729 cases of vulvovaginal candidiasis (VVC) and 113,713 cases of bacterial vaginosis (BV) documented. The corresponding incidence rates were 3.3 and 3.4 per 1,000 person-years.

The incidence of both infections was especially high among women of younger age, low education, limited family income, and who were living in large cities.

In the fully adjusted Cox regression model, sociodemographic factors were strongly linked to the outcomes. Compared with Swedish-born women, those from Middle East/North Africa had the highest risk of VVC (hazard ratio [HR], 2.77, 95 percent confidence interval [CI], 2.72–2.83), followed by those from Africa (excluding North Africa; HR, 2.53, 95 percent CI, 2.45–2.61), and Latin America and the Caribbean (HR, 2.18, 95 percent CI, 2.09–2.27). For BV, the highest risk was seen among women from Latin America and the Caribbean (HR, 1.83, 95 percent CI, 1.75–1.92).

The finding that certain groups of women suffer disproportionately from common vaginal infections may be explained by biological predispositions, such as sociodemographic differences in the vaginal microbiome, or unequal distribution of other risk factors for vaginal dysbiosis.

Additional studies are needed to establish the causal mechanisms involved.