An Intervention to Decrease Intravaginal Practices in HIV-Infected Women in Zambia: A Pilot Study

Alcaide, María L.; Mumbi, Miriam; Chitalu, Ndashi; Jones, Deborah L.

doi:10.1016/j.jana.2012.08.009

Cited by 8 publications

(16 citation statements)

References 14 publications

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“…First, we should develop appropriate public health messages to caution against harmful intravaginal practices. A pilot study among HIV-infected women in Zambia suggested that a behavioral intervention, involving an individual, interactive socio-educational session about intravaginal practices, could decrease these behaviors; communication with sexual partners regarding intravaginal practices was higher for women receiving the intervention [ 24 ]. Educational messages targeted toward or possibly delivered by influential sources of information, such as parents or male partners should also be considered.…”

Section: Discussionmentioning

confidence: 99%

Motivations for Intravaginal Product Use among a Cohort of Women in Los Angeles

et al. 2016

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ObjectiveIntravaginal practices—including behaviors such as intravaginal cleansing and insertion of products—have been linked to a number of adverse reproductive health outcomes, including increased risk for bacterial vaginosis, sexually transmitted infections, and HIV. Currently, little is known about the motivations for intravaginal practices among women in the United States. The objective of this study was to identify and describe motivations for intravaginal washing and intravaginal insertion of products among women of differing ages and racial/ethnic groups.MethodsBetween 2008 and 2010, we enrolled a convenience sample of sexually active women aged 18–65 years living in Los Angeles recruited through community education and outreach activities in HIV/AIDS service organizations, women’s health clinics, community-based organizations, and HIV testing sites. At the enrollment visit, women completed a self-administered, computer-assisted questionnaire covering demographics, sexual behaviors, intravaginal practices, and motivations for intravaginal practices over the past month and past year.ResultsWe enrolled 141 women; 34% of participants were Caucasian, 40% African American, and 26% Latina. Peri-sexual intravaginal washing was common in all groups, whether to clean up after sex (70%) or to prepare for sex (54%). African American women were more likely to report learning to wash intravaginally from their mothers compared to Latina or Caucasian women (70% vs. 49%, P = 0.04). Sixty-one percent of African American women reported using a douching device over the past year compared to 41% of Latina and 40% of Caucasian women (p = 0.02). Younger women were more likely to report that their male partners wanted them to wash intravaginally than older women (77% vs. 24%, P<0.01), and more likely to report the removal of odors as a motive than older women (65% vs. 40%, P = 0.04). The most commonly used intravaginal products included sexual lubricants, petroleum jelly, body lotions, oils, and wet wipes. Use of these products varied by race, and motives given included increasing lubrication, preparing for sex, smelling good, and preventing sexually transmitted infections.ConclusionWomen’s intravaginal practices and motivations for these practices differ across race and age. Motivations for use also vary by type of intravaginal product used. Given that some intravaginal practices have been shown to be harmful, interventions, programs and counseling messages to encourage less harmful practices are needed, and should consider underlying motivations that influence women’s vaginal practices. Practitioners may use these results to better support women in achieving vaginal health.

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Section: Discussionmentioning

confidence: 99%

Motivations for Intravaginal Product Use among a Cohort of Women in Los Angeles

et al. 2016

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“…In the study of Kenyan sex workers, all women who completed the study (n=22, 96%) were in the action stage and no longer engaging in any intravaginal practice, yet the authors reported no change in odds of BV (OR: 1.00; 95% CI 0.42 to 2.38) 15. In the study of HIV-positive Zambian women, the intervention reduced intravaginal practices by 22% in the intervention arm compared with only 6% in the control arm; BV was reduced by 59% in the intervention arm and 47% in the control arm 17. In the trial of young US women the intervention was successful in reducing douching (OR: 1.34; 95% CI 1.03 to 1.73), but BV was not assessed 16.…”

Section: Discussionmentioning

confidence: 98%

“…Other interventions on intravaginal practices using a theoretical framework have been conducted among adolescents in the USA,16 HIV-positive women in Zambia17 and female sex workers in Kenya 15. These interventions ranged in size from 22 women15 to 275 women 16.…”

Section: Discussionmentioning

confidence: 99%

“…The US-based study, a randomised controlled trial, had 15-min individualised counselling sessions at enrolment, 1 month and 3 months 16. The Zambia study had one 8-week follow-up visit after a 20–30 min individual counselling session at enrolment 17. The Kenya study had four weekly visits with structured group sessions 15…”

Section: Discussionmentioning

confidence: 99%

“…A small study in Kenya among female sex workers used a combination of information motivation behavioural skills, TTM and harm reduction models to encourage cessation of vaginal practices 15. An information motivation behavioural skills model was also used successfully in a pilot intervention among HIV-positive women in Zambia 17. To our knowledge, no other vaginal practice cessation intervention has been developed or tested in general population African women (eg, not specialised groups such as sex workers or HIV-positive women).…”

Section: Introductionmentioning

confidence: 99%

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