2 [10]. The classical symptoms associated with the T. vaginalis infection include a yellowish-green frothy discharge, pruritis, dysuria, and the “strawberry” cervix which is characterized by punctuate hemorrhagic lesions. The speciﬁc causes and risk factors associated with bacterial vaginitis are poorly understood; however, associ- ations with sexual activity, use of hygiene products that alter the vaginal ecosystem, and genetic predisposition have been described [11, 12]. If undiagnosed or untreated, these infections might interfere with the women’s reproductive health, being commonly associated with many obstetric con- ditions such as pelvic inﬂammatory disease (PID), premature rupture of membranes (PROM), prematurity, and infertility [4, 5] and also increasing the risk of HIV-1 transmission. Adolescence is a stage of physical and psychological transformation and behavioral experimentation, also being associated with risky sexual behavior in regards to STDs [12, 13]. During this period of life, reproductive hormones cause considerable physiological and tissue changes, which may increase susceptibility to infections. At this stage, the cylindrical epithelium of the endocervical channel is more ectopic and exposed to various agents that commonly infect these tissues [2, 14]. In Brazil, adolescents account for approximately 11% of the population [15]. Few studies have determined the prevalence of vulvovaginitis and associated risk factors among adolescents in Brazil. This population’s health is considered a priority by the National Health Agenda of the Brazilian Ministry of Health. The goal of this study was to determine the prevalence and main risk factors associated with bacterial vaginosis, C. albicans genital infection, and trichomoniasis in a group of female adolescents from Salvador, Bahia, Brazil. 2. Materials and Methods This is a cross-sectional study involving 100 sexually active adolescents followed in the Adolescent Gynecology Clinic (Servic¸o de Ginecologia da Infaˆncia e Adolesceˆncia—SEGIA) of Escola Bahiana de Medicina e Sau´ de Pu´ blica (EBMSP— Salvador, Bahia, Brazil), included between September 2008 and August 2010. By the time of enrollment, all participants have had at least one sexual partner in their lifetime, being considered sexually active. SEGIA is an outpatient clinic that as been oﬀering complete gynecological care to 356 patients since 2008. By August 2010, approximately 37% of patients followed in the clinic were sexually active. Patients were included sequentially at the time of gyneco- logical appointment. Inclusion criteria were female gender, age between 10 and 19, years and sexual activity. Preg- nancy, puerperium, and intravaginal medication use were adopted as exclusion criteria. The study was approved by the Institutional Review Board of EBMSP. An informed consent form was applied and signed by all the legally responsible persons for the adolescents prior to their participation in the study. The patients with 18 years of age or older signed it themselves. All principles outlined in the Declaration of Helsinki were followed. The clinical and demographic data were obtained by applying a semistructured questionnaire. Then, the patients Infectious Diseases in Obstetrics and Gynecology were submitted to gynecological examination. To analyze the growth of Candida species, samples were collected using a vaginal swab dampened with sterile saline, plated aseptically on Sabouraud Dextrose Agar plates (Acumedia Neogene, Lansing, Michigan, USA) and incubated at 35◦C for 24 to 48 hours. White, circular, medium-sized, and catalase positive colonies, observed as Gram-positive yeast in Gram staining, were tested for identiﬁcation of Candida albicans. Positive germ tube test and green stain in CHROMagar Candida (Difco-Becton Dickinson Microbiolgy Systems, Maryland, USA) medium are indicative of these species. The strains that have been tested negative for the germ tube test and have not stained green in the CHROMagar medium were identiﬁed as Candida spp. Smears prepared with vaginal and endocervical spec- imens collected during pelvic examination were Gram stained and observed through optical microscopes (1000X magniﬁcation) by two microbiologists. In order to make the diagnosis of bacterial vaginosis, the bacterioscopy was analyzed according to the scoring system proposed by Nugent et al. [16]. The total score ranges from 0 to 10. BV was diagnosed when the score was equal or higher than seven points. The diagnosis of genital Trichomonas vaginalis infection was made with vaginal cytology using the Papanicolaou’s technique. Protozoan were identiﬁed by their morphological aspects (rounded, pyriform or irregular structures, measur- ing 10 to 20 um, cyanophilic cytoplasm and eccentric small nuclei). Descriptive analysis of all variables was performed, including frequency distributions for ethnic groups, family income, conjugal status, education, alcohol, tobacco and ille- gal drug use, age at ﬁrst sexual intercourse, age at menarche, sexual abuse, use of contraceptives, condom use, and number of sexual partners. The prevalence was calculated with a conﬁdence interval of 95%. Chi-square or Fisher’s exact tests were used for the analysis of categorical variables. Students t- test was used to analyze the numeric data. A value of P ≤ 0.05 was considered statistically signiﬁcant. All data were analyzed using the SPSS 17.0 software (IBM SPSS, Chicago, IL, USA) for Windows. 3. Results One hundred patients were included in this study and all patients invited accepted to participate. The mean age of these individuals was 16.6 ± 1.6 years; 91% were nonwhite and 80% were married or living with a partner; 55% had more than nine years of education; 49% belonged to families with incomes equal to or less than one minimum wage (Table 1). The prevalence of bacterial vaginosis was 20% (95% CI 12–28) and genital infection by Candida albicans or Candida spp. was 22% (95% CI 14–30). Only one patient had genital Trichomonas vaginalis infection. Coinfections by Candida species and T. vaginalis and C. albicans and bacterial vaginosis were observed in two adolescents. Alcohol, tobacco, and illegal drug use was associated with the diagnosis of bacterial vaginosis (P = 0.02). Patients