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A pilot study of the feasibility of a vaginal washing cessation intervention among Kenyan female sex workers.

Abstract：

BACKGROUND:Intravaginal practices including vaginal washing have been associated with HIV-1 acquisition. This association may be mediated by mucosal disruption, changes in vaginal flora or genital tract inflammatory responses. Reducing vaginal washing could lower women's risk of HIV-1 acquisition. METHODS:23 HIV-1 seronegative women who reported current vaginal washing were recruited from a prospective cohort study of high-risk women in Mombasa, Kenya. A theoretical framework including information-motivation-behavioural skills and harm reduction was implemented to encourage participants to reduce or eliminate vaginal washing. At baseline and after 1 month, we evaluated vaginal epithelial lesions by colposcopy, vaginal microbiota by Nugent's criteria and vaginal cytokine milieu using ELISA on cervicovaginal lavage specimens. RESULTS:The most commonly reported vaginal washing substance was soap with water (N=14, 60.9%). The median frequency of vaginal washing was 7 (IQR 7-14) times per week. After 1 month, all participants reported cessation of vaginal washing (p=0.01). The probability of detecting cervicovaginal epithelial lesions was lower (OR 0.48; 95% CI 0.20 to 1.16; p=0.10) and the likelihood of detecting Lactobacillus by culture was higher (OR 3.71, 95% CI 0.73 to 18.76, p=0.11) compared with baseline, although these results were not statistically significant. There was no change in the prevalence of bacterial vaginosis. Most cytokine levels were reduced, but these changes were not statistically significant. CONCLUSIONS:A theory-based intervention appeared to have a positive effect in reducing vaginal washing over 1 month. Larger studies with longer follow-up are important to further characterise the effects of vaginal washing cessation on biological markers.

journal_name

Sex Transm Infect

journal_title

Sexually transmitted infections

authors

Masese L,McClelland RS,Gitau R,Wanje G,Shafi J,Kashonga F,Ndinya-Achola JO,Lester R,Richardson BA,Kurth A

doi

10.1136/sextrans-2012-050564

subject

Has Abstract

pub_date

2013-05-01 00:00:00

pages

217-22

issue

eissn

1368-4973

issn

1472-3263

pii

sextrans-2012-050564

journal_volume

pub_type

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A pilot study of the feasibility of a vaginal washing cessation intervention among Kenyan female sex workers.