Understanding intra-vaginal and labia minora elongation practices among women heads-of-households in Zambézia Province, Mozambique

Abstract

Background Intra-vaginal drying and tightening and labia minora elongation are commonly practiced in some parts of southern Africa. We sought to capture data on these practices among women living in Zambézia province, Mozambique. Methods We gathered information from 3,543 female heads of household on >500 variables, including vaginal practices in 2014. Weighted percentages of survey responses are reported. Results Women who planned to use intra-vaginal tightening substances had 1.84 times higher odds of ever receiving an HIV test (p<0.001) and 1.40 times higher odds of at least one ANC visit attended during last pregnancy (p=0.015). Women who had or planned to undergo labia minora elongation had 2.61 times higher odds of receiving an HIV test in the past (p<0.001) and 1.60 times higher odds of attending at least one ANC visit during their last pregnancy (p<0.001). There was little evidence for a relationship between self-reported HIV status and anticipated use of intra-vaginal tightening substances (p=0.21). Current or anticipated participation in labia elongation showed a protective effect on HIV infection (p=0.028). Conclusion Given documented associations between intra-vaginal substance use, vaginal infections, and HIV acquisition, understanding the prevalence of vaginal practices may be an essential component to addressing the epidemic.

Consideration of Cultural Practices When Characterizing the Vaginal Microbiota Among African and African American Women

“…Despite its technical distinction, Gukuna is classified by the World Health Organization (WHO, 2008) as type IV FGM, which carries a negative connotation even if it is not a mutilation per se (Koster & Price, 2008). The aim of labial elongation is to provide enhanced sexual pleasure during intercourse to both the female and her partner through Kunyaza , which is a rhythmic sexual technique aimed at providing multiple orgasms and female ejaculation during intercourse among other supposed benefits (Audet et al, 2017; Bizimana, 2010). To date, there are no reports on the effect of elongation of the labia minora on genitourinary tract infection, any other inflammatory process, or on the vaginal microbiota.…”