Vaginal douching among women of reproductive age in the United States: 1988.

Aral, Sevgi O.; Mosher, William D.; Cates, W

doi:10.2105/ajph.82.2.210

Cited by 119 publications

(66 citation statements)

References 11 publications

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“…We did not have reliable information on condom use in this group of women. Alternatively, it is possible that practices, such as douching, which is reportedly more common in black women and can increase susceptibility to infection, [14][15][16] could predispose to trichomoniasis and explain the racial association observed. We did not obtain information on the practice of douching in this cohort of women.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for trichomoniasis among women with human immunodeficiency virus (HIV) infection at a public clinic in Los Angeles County, California: implications for HIV prevention.

Sorvillo

Kovacs²,

Kerndt³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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Abstract. Persons with human immunodeficiency virus (HIV) infection who subsequently develop an acute sexually transmitted disease have an increased probability of transmitting HIV. Therefore, characterizing such persons can help direct prevention efforts to a group who are likely to be continuing sources of HIV transmission. We assessed the incidence and factors associated with trichomoniasis in a cohort of HIV-infected women receiving care at a public clinic in Los Angeles County, California from 1992 through 1995. Demographic, clinical, and behavioral data were available from medical records and from patient interviews. Trichomonas infection was the most frequently identified sexually transmitted disease and was found in 37 (17.4%) of 212 women representing a crude incidence rate of 14.1 per 100 person-years experience. The crude rate of trichomoniasis was highest in black women (69.0 per 100 personyears), women with a history of trading sex for drugs or money (51.0 per 100 person-years), those using crack or cocaine (35.5 per 100 person-years), women with four or more sex partners (43.0 per 100 person years), and those born in the United States (23.3 per 100 person-years). Among women with severe immunosuppression (CD4ϩ count Ͻ 200), 18.4% (18 of 98) were diagnosed with trichomoniasis. After multivariate analysis using a Cox proportional hazards approach, black race (adjusted rate ratio [RR] ϭ 5.6, 95% confidence interval [CI] ϭ 2.3, 13.3) continued to be strongly associated with Trichomonas infection. Trading sex for money or drugs (adjusted RR ϭ 25.2, 95% CI ϭ 4.3, 148.6) and single marital status (adjusted RR ϭ 3.7, 95% CI ϭ 1.1, 13.0) were independent risk factors for trichomoniasis in nonblack women but not among black women. Data from this study indicate that Trichomonas may be a frequently acquired infection in HIV-positive women. Our findings suggest that HIV-infected women who are black, and nonblack women who trade sex for money or drugs or are unmarried, are at increased risk of trichomoniasis and therefore may be more likely to transmit HIV infection. Local HIV prevention strategies should target such women for intervention efforts.

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Section: Discussionmentioning

confidence: 99%

Risk factors for trichomoniasis among women with human immunodeficiency virus (HIV) infection at a public clinic in Los Angeles County, California: implications for HIV prevention.

Sorvillo

Kovacs²,

Kerndt³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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“…Vaginal douching is widely practiced by American women and is more frequent and more common among minority women and among women of lower socioeconomic status [1][2][3]. Between 1988 and 1995, rates of douching declined overall among women in the United States but dropped least among minority groups to 55% of Black women, 34% of Latinas, and 53% of lower SES women engaging in vaginal douching [2].…”

Section: Introductionmentioning

confidence: 99%

Vaginal Douching Among Latinas: Practices and Meaning

McKee

Baquero

Anderson

et al. 2008

Matern Child Health J

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Objectives-Vaginal douching is widely practiced by American women, particularly among minority groups, and is associated with increased risk of pelvic and vaginal infections. This research sought to investigate vaginal hygiene practices and meaning associated with them among Latina women and adolescents. Study results would guide development of an intervention to decrease douching among Latinas.Methods-In depth qualitative interviews conducted with English-and Spanish-speaking women aged 16-40, seeking care for any reason who reported douching within the last year (n = 34). Interviews were audiotaped, transcribed and analyzed using qualitative methods. One-third of interviews were conducted in Spanish.Results-Two explanatory models for douching motives emerged: one stressed cosmetic benefits; the other, infection prevention and control. Most women reported douching to eliminate menstrual residue; a small number reported douching in context of sexual intercourse or vaginal symptoms. Many were unaware of associated health risks. Respondents typically learned about douching from female family members and friends. Male partners were described as having little to no involvement in the decision to douche. Women varied in their willingness to stop douching. Two-thirds reported receiving harm reduction messages about "overdouching". About half indicated previous discussion about douching with health care providers; some had reduced frequency in response to counseling. A number of previously unreported vaginal hygiene practices and products were described, including use of a range of traditional hygiene practices, and products imported from outside the US.Conclusions-Respondents expressed a range of commitment to douching. Counseling messages acknowledging benefits women perceive as well as health risks should be developed and delivered tailored to individual beliefs. Further research is needed to assess prevalence and safety of previously unreported practices.

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“…The few studies examining this practice more closely suggest that vaginal douching is more likely to be practiced by women who are unmarried, less educated, had less income, lived in the southern United States, and were of African-American descent (Aral, Mosher, & Cates, 1992;Fiscella et al, 1998). However, less work has been done in populations with high rates of douching, such as black or low-income women, to go beyond sociodemographic factors and identify variables within these groups that predict douching.…”

Section: Introductionmentioning

confidence: 99%