P378 A wide variety of intravaginal practices should be considered in research studies in rural South Africa

Abstract

Background The vaginal microbiome and genital tract inflammation play an important role in HIV transmission and birth outcomes in South Africa. Intravaginal practices (IVPs) such as cleansing may influence the microbiome and levels of inflammation. IVPs are commonly practiced by women in South Africa, however, studies generally only include collection of data on cleansing and insertion of herbs. Methods We conducted an exploratory study to obtain insight in the variety of IPVs practiced by women in the rural Eastern Cape province of South Africa. Group discussion was held with participants (n=10) in an STI workshop and additional information was obtained through snowballing. Participants were two medical doctors, two project managers, two nurses, and four counsellors/social workers. IPVs that participants were aware of or had heard about were recorded. Results Other than intravaginal cleansing and insertion of herbs, participants had knowledge of women inserting a variety of substances in their vagina such as snuff (tobacco powder), ice cubes, toilet refreshener, Chinese pills, uvutha wabafazi (a traditional vaseline-like ointment), Indian holy ash, soft drinks and Vicks VapoRub. Intravaginal use of live organisms (Kombucha aka Amoeba mabhebeza, frogs and snakes) was also known. In addition, genital steaming practice is common using water with salt, onion, avocado seeds, guava leaves. Finally, external and internal sanitary packs created of potato sack or newspaper are used. The purpose of all these practices was to enhance male sexual pleasure, genital health, for sexual fortune and energy, and for traditional healing purpose. Conclusion Studies of genital tract microbiome and inflammation in women in rural South Africa should take a wide range of IPVs into account. Further research is required to document the frequency and geographic spread of these practices, and their impact on genital health.