Bacterial vaginosis (BV) is one of the leading vaginal infections amongst reproductive aged women in the United States. While up to 29.2 million cases are recorded annually according to the CDC, the percentages by race vary widely. For example, white women have a rate of 23%, whereas Hispanic women have a rate of 32% and black women a rate of 51%. This is staggering that the rate of BV in women of color, especially in African American women, is twice as high as white women. In women of Sub-Saharan Africa, the percentage is even higher.
Why is this? A 2016 study in the American Journal of Reproductive Immunology links key demographic and behavioral factors including “race, age, the number of sexual partners, and the use of hormonal contraceptives” (see study link) amongst other things. However, another key finding from the study is that women of African lineage tend to have a vaginal microbiome with a distinctly different makeup of lactobacilli than women of European descent.
The Vaginal Microbiome
Findings show that African American women have a higher resting vaginal pH level (over 4.5), which is higher than the recommended levels (3.8-4.5 pH) and also are more likely to have vaginal tracts populated by the lactobacilli iners bacteria compared to the lactobacilli crispatus strain that is more common in the vaginal tracts of women with European descent.
In addition to all these factors, Kaiser Health News reports that African American women are three times more likely than white women to have a Vitamin D deficiency.
This happens because the higher amount of melanin in their skin makes them less likely to absorb the vitamin from the sun. Unfortunately, vitamin D deficiency is also linked to increased risk of bacterial vaginosis.
Implicit Bias and Discrimination
We must be able to admit and come to terms with the discrimination that African American women face when going to the doctor. They are disproportionately not believed and their pain is not taken seriously.
We must begin correcting the systems that keep quality health information from getting communicated to and given to African American women. Finally, researchers are working on trials in giving African American women with recurrent BV lactobacilli treatment alongside the ordinary antibacterial treatments they receive typically.
More education on healthy feminine hygiene products and personal lubricants can be especially helpful in preventing the outbreaks of BV amongst African American women.
Good Clean Love is proud to offer both education and medical sampler kits to medical clinics and organizations. If you are a healthcare provider who works with women of color, please don’t hesitate to reach out to join our medical sampler program. We are committed to doing our part to increase health outcomes for women of color.