title: Intravaginal practices, vaginal flora disturbances, and acquisition of sexually transmitted diseases in Zimbabwean women.
abstract: One hundred sixty-nine Zimbabwean women were studied to determine whether the use of intravaginal practices (cleaning with the fingers, wiping the vagina, and inserting traditional substances) are associated with disturbances of vaginal flora and acquisition of sexually transmitted diseases (STDs). Subjects were interviewed and received counseling and a pelvic examination at enrollment, 1 month, and 6 months, and vaginal specimens were collected at enrollment and at 6 months. Users were more likely than nonusers to have vaginal flora disturbances but were not more likely to acquire an STD (relative risk [RR], 2.15; P=.188). Certain vaginal flora disturbances were associated with increased STD incidence and HIV prevalence. The absence of lactobacilli from the vaginal flora was associated with being positive for human immunodeficiency virus in baseline (odds ratio [OR], 0.24; P=.001) and 6-month transition multivariate models (OR, 0.39; P=.025). The presence of clue cells at baseline was associated with a higher incidence of STDs (RR, 1. 94; P=.025).
authors.affiliation: The Population Council, New York, NY 10017, USA. jvandewijgert@popcouncil.org
authors.forename: J H
authors.initials: JH
authors.lastname: van De Wijgert
authors.forename: P R
authors.initials: PR
authors.lastname: Mason
authors.forename: L
authors.initials: L
authors.lastname: Gwanzura
authors.forename: M T
authors.initials: MT
authors.lastname: Mbizvo
authors.forename: Z M
authors.initials: ZM
authors.lastname: Chirenje
authors.forename: V
authors.initials: V
authors.lastname: Iliff
authors.forename: S
authors.initials: S
authors.lastname: Shiboski
authors.forename: N S
authors.initials: NS
authors.lastname: Padian
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000635:transmission; D006801:Humans; D006920:Hygiene; D015994:Incidence; D007778:Lactobacillus / Q000302:isolation & purification; D016017:Odds Ratio; D015995:Prevalence; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D011795:Surveys and Questionnaires; D014621:Vagina / Q000166:cytology / Q000382:microbiology*; D015030:Zimbabwe / Q000453:epidemiology