Vaginal douching and association with sexually transmitted infections among female sex workers in a prefecture of Yunnan Province, China

Abstract

Vaginal douching is a common practice and has been hypothesised to increase a woman's risk for human of contracting HIV and sexually transmitted infections (STIs). Our objective was to assess the prevalence of douching and its association with STIs, genital symptoms and HIV/STI knowledge among female sex workers (FSWs). We conducted a cross-sectional study of 837 FSWs with interviews and laboratory tests for HIV/STIs in a prefecture of Yunnan Province in southern China. Vaginal douching was reported by 84% of the women. We found a higher prevalence of vaginal douching practice among FSWs of Han ethnicity, and who were single or cohabitating. Douching was also significantly more common among more educated FSWs and those with greater knowledge of HIV/STIs, and as well as in FSWs who had experienced clinical symptoms in the previous 12 months. Douching was linked to higher risks of HIV (adjusted odds ratio = 2.29; 95% confidence interval 1.01-5.23) and herpes simplex virus type 2 infections (adjusted odds ratio = 2.18; 95% confidence interval 1.46-3.24) after adjusting for confounding factors. Medical professionals and public health workers should correct women's misconception about the effectiveness of douching and discourage women from douching through educational activities. More prospective studies among FSWs are urgently required to identify the relationship between vaginal douching and HIV/STIs.

Douching practices among women in the Bolgatanga municipality of the upper east region of Ghana

“…Ekpenyong et al, reported a prevalence of 80% among young adult women in Nigeria. Furthermore, our prevalence rate is lower than the 84% reported among sex workers in Yunnam Province in China [21]; the 72% among women attending reproductive health clinic in Dar es Salaam in Tazania [19]. However, the reported prevalence in this study is higher than the 46% reported among black women at risk in Southern United States [6].…”

Rectal douching in a community sample of men and women

“…35 The negative impact that routine douching can have on women’s reproductive health and vulnerability to HIV/AIDS and STIs has also been studied. 36 Our study found a strong association of RD prior to RAI with syphilis.…”

The Prevalence of Reproductive Tract Infections in a Chinese Internal Migrant Population, and Its Correlation with Knowledge, Attitude, and Practices: A Cross-Sectional Study

“…In this study, frequent cleaning of one’s genitals and bathing have been associated with a high prevalence of STIs. Although, STIs are mostly caused by pathogens via unsafe and unprotected sexual behavior with multiple sexual partners or disloyal partners, many studies have demonstrated that genital hygiene practices also correlate with higher risks of STIs [35,36,37]. Inappropriate cleaning methods, such as vaginal touching, use of feminine wipes and alkaline lotion for genital and reproductive tract inevitably increase the chances of infection.…”