Intravaginal Practices, Vaginal Flora Disturbances, and Acquisition of Sexually Transmitted Diseases in Zimbabwean Women

Abstract

One hundred sixty-nine Zimbabwean women were studied to determine whether the use of intravaginal practices (cleaning with the fingers, wiping the vagina, and inserting traditional substances) are associated with disturbances of vaginal flora and acquisition of sexually transmitted diseases (STDs). Subjects were interviewed and received counseling and a pelvic examination at enrollment, 1 month, and 6 months, and vaginal specimens were collected at enrollment and at 6 months. Users were more likely than nonusers to have vaginal flora disturbances but were not more likely to acquire an STD (relative risk [RR], 2.15; P=.188). Certain vaginal flora disturbances were associated with increased STD incidence and HIV prevalence. The absence of lactobacilli from the vaginal flora was associated with being positive for human immunodeficiency virus in baseline (odds ratio [OR], 0.24; P=.001) and 6-month transition multivariate models (OR, 0.39; P=.025). The presence of clue cells at baseline was associated with a higher incidence of STDs (RR, 1. 94; P=.025).

Seroepidemiology of Trichomonas vaginalis in rural women in Zimbabwe and patterns of association with HIV infection

“…The overall seroprevalence of HIV in this rural cohort was slightly lower than reported in studies of pregnant (33 %) [18] or non-pregnant (30-35%) [19] women in Harare. This is consistent with many studies showing small differences in HIV prevalence between urban and rural communities, and such differences have also been noted when comparing small urban sites and rural sites in this study area [12].…”

Characterization of vaginal microbial communities in adult healthy women using cultivation-independent methods

“…Previous studies on the microbial flora of the human vagina indicate that micro-organisms normally present in the human vagina play a key role in preventing successful colonization by 'undesirable' organisms, including those responsible for bacterial vaginosis, yeast infections, sexually transmitted diseases and urinary tract infections (Donders et al, 2000;Gupta et al, 1998;Sobel, 1999;van De Wijgert et al, 2000). Moreover, epidemiologic studies have clearly established that abnormal vaginal microbial communities and lower genital tract infections are significantly associated with an increased risk of HIV infection (Cohen et al, 1995;Martin et al, 1999;Sewankambo et al, 1997).…”

Phenotypic characterization and genomic DNA polymorphisms of Escherichia coli strains isolated as the sole micro-organism from vaginal infections

“…Studies of the microbial flora of the human vagina reveal that microorganisms normally present in this habitat play an important role in preventing colonization by exogenous bacterial species (Donders et al, 2000;van De Wijgert et al, 2000). The vaginal microflora is usually constituted by 5-15 different bacterial species (Obata-Yasuoka et al, 2002), normally characterized by a high number of Lactobacillus species.…”