A case–control study on the association between female genital mutilation and sexually transmitted infections in Sudan

Abstract

Objective To assess whether the extent of female genital mutilation (FGM) influences the risk of acquiring sexually transmitted infections (STIs).Design Hospital-based case-control study.Setting Two obstetric/gynaecological outpatient clinics in Khartoum, Sudan, 2003Sudan, -2004 Population A total of 222 women aged 17-35 years coming to antenatal and gynaecological clinics.Methods Women recruited for the study were divided into cases with seropositivity for Neisseria gonorrhoeae (gonococcal antibody test), Chlamydia trachomatis (enzyme immunoassay) or Treponema pallidum (Treponema pallidum haemagglutination assay) (n = 26) and controls without antibodies to these species (n = 196). Sociodemographic data were obtained and physical examination including genital examination was performed in order to classify the form of FGM. Cases and controls were compared using logistic regression to adjust for covariates.Main outcome measures Extent of FGM and seropositivity for C. trachomatis, N. gonorrhoeae or T. pallidum.Results Of the cases, 85% had undergone the most severe form of FGM involving labia majora compared with 78% of controls (n.s.). Thus, there was no association between serological evidence of STIs and extent of FGM. The only factor that differed significantly between the groups was the education level, cases with STIs having significantly shorter education (P = 0.03) than controls.Conclusions There is a little difference between cases and controls in regard to FGM. Having in mind the relatively small sample size, the results still indicate that FGM seems neither to be a risk factor for nor protective against acquiring STIs. This is important as argument against traditional beliefs that FGM protects against pre/extramarital sex.

Factors Associated with HIV/AIDS in Sudan

“…Vaginal intercourse is difficult, often resulting in tissue damage, lesions, and postcoital bleeding. These tears would tend to make squamous vaginal epithelium similar in permeability to the columnar muscosa of the rectum, thus facilitating the possible transmission of HIV [14]. A great deal of anal sexual intercourse takes place in cases where the female is circumcised [15].…”

Female Genital Cutting

“…Screening for sexually transmitted infections (STI) is advisable because FGC has been shown not to reduce exposure to STIs. 5 These teens should also be screened for HIV because FGC is often performed with unsterile instruments that are used on multiple females.…”

Female Genital Mutilation in a Young Refugee: A Case Report and Review

“…So, FGM is decried as a violent form of child abuse (Menage, 2006;Schroeder, 1994) and a human rights violation whose purpose is the subjugation and control of women (Barstow, 1999), but it is also defended as part of the elaborate rules and cultural systems that are transmitted from generation to generation, usually among women, as a rite of passage, as a key feature of a woman's identity (Corbett, 2008), and as a deterrent against premarital intercourse (Braddy & Files, 2007). It has even been seen as a protective measure against sexually transmitted disease, even though some studies indicate that women who have undergone FGM do not have decreased rates of sexually transmitted disease (Elmusharaf, Elkhidir, Hoffmann, & Almroth, 2006;Msuya et al, 2002) and, as noted in the introduction, may have increased risk of contracting HIV. With respect to gender, a particular interesting study by Almroth et al (2001) documented that a significant number of men living in a country where FGM is practiced object to FGM and report their own negative psychological, sexual, and even physical consequences of FGM.…”