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Bacterial vaginosis (BV) affects one-in-four reproductive-aged women, is challenging to cure and is associated with preterm birth, miscarriage and increased risk of acquiring sexually transmitted infections (STIs) and HIV. 1 To date, global guidelines recommend treating only women with antibiotics, a strategy that results in recurrence rates over 50%,2 rising to 60–80% among women with ongoing male partners.2 3