title: Interrelationships among douching practices, risky sexual practices, and history of self-reported sexually transmitted diseases in an urban population.
abstract: OBJECTIVE
  To describe the interrelationships of douching, sex during menses, dry sex, and anal intercourse and their associations with self-reported history of sexually transmitted diseases (STD).
  
  
  METHODS
  The authors interviewed by telephone 422 white Americans (WA) and 44 African Americans (AA) selected using random-digit dialing, and 135 AA selected from a listed sample of census tracks having a population of at least 40% AA.
  
  
  RESULTS
  After adjusting for lifetime numbers of vaginal sex partners, sex during menses was associated with self-reported history of chlamydial infection among women (WA: odds ratio [OR] = 3.9; confidence interval [CI]: 1.1, 14.0; AA: OR = 1.6; CI: 0.6, 4.2). Anal sex was associated with self-reported history of genital warts, genital herpes, hepatitis, and gonorrhea; douching with a twofold increase in self-reported pelvic inflammatory disease. Anal sex was most common in women with a history of same- and opposite-sex partners.
  
  
  CONCLUSIONS
  These data confirm the association of douching and anal sex with various STD and suggest that sex during menses is associated with chlamydial infection.
authors.affiliation: Department of Epidemiology, University of Michigan, School of Public Health, Ann Arbor 48109-2029, USA.
authors.forename: B
authors.initials: B
authors.lastname: Foxman
authors.forename: S O
authors.initials: SO
authors.lastname: Aral
authors.forename: K K
authors.initials: KK
authors.lastname: Holmes
mesh_terms: D000328:Adult; D003710:Demography; D005260:Female; D006801:Humans; D008598:Menstruation; D012309:Risk-Taking; D012655:Self-Evaluation Programs; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D007507:Therapeutic Irrigation; D014505:Urban Population; D014861:Washington / Q000453:epidemiology