Prevalence and Correlates of Recent Vaginal Douching among African American Adolescent Females

Abstract

Study objective To describe the prevalence and correlates of vaginal douching among urban African American adolescents and to examine the association between douching and STI status. Design: Demographic, psychosocial, and behavioral data were collected through cross-sectional, self-administered surveys. Self-collected vaginal swabs were assayed using NAAT for trichomoniasis, Chlamydia, and gonorrhea. Setting Sexual health clinic in a large metropolitan area of the Southeast Participants African American females (N=701) ages 14 to 20 participating in an HIV prevention intervention Main outcome measure The outcome of interest was the association between vaginal douching (lifetime, past 90 days, and past 7 days) with demographic characteristics (e.g. age, education, and socioeconomic status), physical and mental health status, STI status, sexual behavior (e.g. number of vaginal sexual partners, age of sex partners, consistent condom use in the past 90 days, sex while self/partner was high on drugs or alcohol), and psychosocial characteristics (e.g. sexual adventurism, social support, peer norms, sexual happiness, self-efficacy for sex refusal, self-esteem, relationship power, risk avoidance). Results Forty-three percent reported ever douching, and 29% reported douching in the past 90 days. In bivariate analyses, recent douching was associated with demographic, behavioral, and psychosocial variables, but not current STI status. In multivariate analyses, recent douching was associated with age (AOR=1.13, CI=1.02–1.25), lower socio-economic status (AOR=1.25, CI=1.05–1.47), and having sex with much older partners (AOR=1.87, CI=1.22–2.86). Conclusion Increased age, lower socioeconomic status, and older partners may be salient risk factors for douching behavior among African American young women.

Douching Practices among Hausa-Fulani Pregnant Women With and Without Bacterial Vaginosis in Zaria, Northwest Nigeria

“…Douching was observed more among women with no formal education or among those with only primary education. This agrees with other studies that douching is more prevalent among females of low educational [15,39] and socioeconomic status [7]. However, our result of douching being more prominent in younger age groups was in contrast with what Declemente et al reported [7].…”

“…Sources of BVF which collect in the vagina are from the peritoneal fluid, fluid from the entire uterine system which includes the follicles, the fallopian tubes, the uterus itself, the cervix and the vaginal The epidemiology of douching, women's behavioral pattern to it, substances used and reasons behind douching as well as its health implication have been studied extensively, mostly outside of Africa [2,3]. Surveys have shown that douching practice was common in the United States [4,5] Martino, et al stated that [6] douching prevalence varies according to race, and age cohort and Diclemente argued that increased age [7], lower socioeconomic status, and older partners are probable relevant risk factors for douching among African American adolescents.…”

Vaginal douching behavior among young adult women and the perceived adverse health effects

“…Earlier studies have observed a significant correlation between factors that depict individual socio-economic status and health awareness and practices. Socio-economic status may influence health by limiting access to preventative and treatment services and shaping health behaviors (Santelli et al, 2000;Simms and Stephenson, 2000;Diclemente et al, 2012). Hence, socio-economically disadvantaged populations are likely to be strongly affected by various health problems and adopt practices such as VD that may result in increased risks of gynecological problems.…”

“…Hence, socio-economically disadvantaged populations are likely to be strongly affected by various health problems and adopt practices such as VD that may result in increased risks of gynecological problems. In addition, worse health indicators (such as high prevalence of VD) are common in such populations, suggesting that women in low socio-economic classes douche more often than those in high socioeconomic classes (Cotrell, 2005;Diclemente et al, 2012).…”

Addressing intravaginal practices in women with HIV and at-risk for HIV infection, a mixed methods pilot study

“…In sub-Saharan Africa, IVPs are used for cleansing, and intravaginal insertion is used to create a warm and tight vaginal environment to please male partners, a partner preference associated with traditional and cultural expectations of women 15–17. Among HIV-uninfected women in the US, douching is common and primarily motivated by vaginal hygiene 18,19. Few studies have addressed IVP among HIV-infected women, in whom IVP may be implicated in the development of BV, obstetric and gynecological complications, and HIV transmission 2,6–11…”