Q. A 32-year-old female presents to the emergency department with a complaint of vaginal discharge and odor for the past two weeks. She reports that the discharge is grayish-white and has a fishy odor. She also mentions that she has experienced some mild discomfort and itching in her vaginal area. The patient has a medical history of uncontrolled diabetes mellitus and a recent history of unprotected sexual intercourse. On physical examination, the patient has a temperature of 99.1 degrees Fahrenheit, and her blood pressure is within the normal range. On pelvic examination, the vaginal walls are erythematous, and a thin, grayish-white discharge is noted. No cervical motion tenderness or adnexal tenderness is present. A wet mount preparation of the vaginal discharge is obtained (see image), and the presence of clue cells and a fishy odor on whiff test is detected. The patient is started on metronidazole 500 mg orally twice a day for 7 days. She is also advised to avoid sexual intercourse until the symptoms resolve. Which of the following can you advise her is NOT an additional risk factor for her diagnosis?