Examining Women's Self-Management Strategies for Recurrent Bacterial Vaginosis in New York City.

Introduction: Bacterial vaginosis (BV) is the most prevalent vaginal condition among women, yet limited data exist on how women manage recurring BV and their perceptions of BV triggers. This study aimed to explore women's experiences with BV onset and recurrence, the various self-treatment strategies used, and adherence to medication regimens.

Methods: From March 2020-May 2022, we recruited females at birth ages ≥18 years, who had received a BV diagnosis within the past year at one of four New York City Department of Health and Mental Hygiene (NYC DOHMH) sexual health clinics (SHCs) to take part in semi-structured interviews.

Results: A total of 41 women participated, with over half (n = 23) from the SHC in the Bronx.Most women identified as non-Hispanic or Hispanic Black (n = 32), and nearly a quarter as bisexual (n = 8). Women cited sexual (e.g., partner infidelity) and non-sexual (e.g., diet, perfumed soaps) triggers for BV recurrence. To reduce BV recurrence, women reported engaging in self-management strategies like dietary and hygiene changes, including some practices (e.g., increased douching) that are known to exacerbate BV. Some women reported low adherence to the seven-day metronidazole pill regimen, primarily due to side effects.

Discussion: Findings highlight self-management strategies women use to reduce BV recurrence and indicate further education about which strategies may be helpful or harmful is needed. Some patients may need additional BV medication adherence support for multi-day dosing of oral metronidazole or access to alternate treatment regimens.