title: Vaginal douching, condom use, and sexually transmitted infections among Chinese female sex workers.
abstract: OBJECTIVE
  Vaginal douching has been hypothesized to increase a woman's risk for human immunodeficiency virus (HIV) infection. However, data on the prevalence of this practice and its association with condom use and sexually transmitted infections (STIs) are limited.
  
  
  METHODS
  A cross-sectional survey among 454 female sex workers (FSWs) in a Chinese county.
  
  
  RESULTS
  Vaginal douching was reported by 64.7% of the women. The prevalence of self-reported history of STI and that of current STI was 19.4% and 41.5%, respectively. Fifteen percent of the women reported consistent use of condoms with their clients and 8.4% with their regular partners. Vaginal douching was significantly associated with decreased use of condoms (with clients: OR = 0.31; with regular partner(s): OR = 0.22) and increased rate of self-reported STI history (OR = 1.95). However, there was no direct relation between douching and current STI. Over one third of the women believed that douching can prevent STI/HIV.
  
  
  CONCLUSIONS
  Vaginal douching exposes FSWs to a high risk of STI/HIV. Medical professional and public health workers should correct women's misconception about the effectiveness of douching and discourage women from douching through educational activities.
authors.affiliation: The Carman and Ann Adams Department of Pediatrics Prevention Research Center, Wayne State University, Detroit, MI 48201, USA. bwang@med.wayne.edu
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Li
authors.forename: Bonita
authors.initials: B
authors.lastname: Stanton
authors.forename: Hongmei
authors.initials: H
authors.lastname: Yang
authors.forename: Xiaoyi
authors.initials: X
authors.lastname: Fang
authors.forename: Ran
authors.initials: R
authors.lastname: Zhao
authors.forename: Baiqing
authors.initials: B
authors.lastname: Dong
authors.forename: Yuejiao
authors.initials: Y
authors.lastname: Zhou
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Shaoling
authors.initials: S
authors.lastname: Liang
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D011477:Sex Work; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000635:transmission; D044364:Vaginal Douching