Evaluation of two self-care treatments for prevention of vaginal candidiasis in women with HIV.
Vaginal candidiasis (VC) is a common concern for women living with HIV infection. The authors evaluated the effectiveness of two self-care approaches to prophylaxis of VC among HIV-infected women, weekly intravaginal application of Lactobacillus acidophilus or weekly intravaginal application of clotrimazole tablets, in a randomized, double-blind, placebo-controlled trial. VC was defined as a vaginal swab positive for Candida species in the presence of signs/symptoms of vaginitis and the absence of a diagnosis of Trichomonas vaginalis or bacterial vaginosis. Thirty-four episodes of VC occurred among 164 women followed for a median of 21 months. The relative risk of experiencing an episode of VC was 0.4 (95% CI = 0.2, 0.9) in the clotrimazole arm and 0.5 (95% CI = 0.2, 1.1) in the Lactobacillus acidophilus arm. The estimated median time to first episode VC was longer for clotrimazole (p = .03, log rank test) and Lactobacillus acidophilus (p = .09, log rank test) compared with placebo. Vaginal yeast infections can be prevented with local therapy. Education about self-care for prophylaxis of VC should be offered to HIV-infected women.
Williams
A B
AB
Yale University School of Nursing, USA.
Yu
C
C
Tashima
K
K
Burgess
J
J
Danvers
K
K
D000282:Administration, Intravaginal; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D002181:Candidiasis, Vulvovaginal / Q000451:nursing / Q000517:prevention & control* / Q000821:virology; D003022:Clotrimazole / Q000627:therapeutic use*; D000529:Complementary Therapies / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000382:microbiology / Q000451:nursing; D006801:Humans; D007779:Lactobacillus acidophilus; D012306:Risk; D012648:Self Care / Q000379:methods*; D018709:Statistics, Nonparametric; D016019:Survival Analysis
D000935:Antifungal Agents; D003022:Clotrimazole