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We read with interest the article by Hickey et al. (1), which enrolled 31 healthy, asymptomatic premenarcheal girls (primarily Tanner stages 2 or 3) aged 10 to 12 years (of whom 67% were African American) with no history of sexual contact whose vulvar and vaginal microbiota were monitored quarterly for up to 3 years. Lactobacillus species were dominant in the vaginal microbiota of most girls before the onset of menarche in the early-middle stages of puberty (as the production of estrogen during puberty causes a change in the vaginal flora to lactobacillus predominance) (2). However, Gardnerella vaginalis was detected in appreciable levels in approximately 1/3 of women. This is of significant interest given that G. vaginalis has been the bacterium most extensively studied in relationship to the pathogenesis of bacterial vaginosis (3–5). Several limitations of this study may have confounded the G. vaginalis results.This study, like others (6–9), has the …

Accuracy of Self-Report of Sexual Activity among Adolescent Girls: Implications for Interpretation of Vaginal Flora Patterns