title: Use of lemon or lime juice douches in women in Jos, Nigeria.
abstract: OBJECTIVE
  To describe the use of lemon/lime juice for douching by female sex workers (FSWs) and family planning clients (FPCs) in Jos, Nigeria.
  
  
  METHODS
  A total of 300 sexually active women comprising 200 FSWs and 100 FPCs were interviewed in June 2004 to determine the mode and rationale for the use of lemon/lime juice for sex.
  
  
  RESULTS
  Majority of the women 167/300 (55.7%, 95% CI = 50-61%) i.e. 163/200 (81.5%, 95% CI = 75-87%) FSWs, 4/100 (4%, 95% CI = 1-10%) FPCs used vaginal lemon/lime douches. Lime juice was used by 105/167 (62.8%, 95% CI = 55-70%), lemon juice by 30/167 (18%, 95% CI = 12-25%) or a mixture by 18/167 (10.8%, 95% CI = 7-25%). The juice was used either neat 44/167 (26%, 95% CI = 20-34%) or diluted in water 75/167 (45%, 95% CI = 37-53%) either before or after sex. Nineteen per cent (32/167) found the juice painful. Over half of the women believed that it protected them from pregnancy and/or sexually transmitted infections; they did not know their HIV status. Eighty-six per cent would recommend it to others, and 71% would be willing to take part in a study to evaluate its safety and efficacy.
  
  
  CONCLUSIONS
  Lemon and lime juice are widely used for douches among women at high risk of HIV transmission. There is an urgent need to determine whether or not this practice promotes or prevents HIV infection.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Jos, PMB 2084, Jos, Nigeria. ereimade@yahoo.co.uk
authors.forename: Godwin E
authors.initials: GE
authors.lastname: Imade
authors.forename: Atiene S
authors.initials: AS
authors.lastname: Sagay
authors.forename: Viola A
authors.initials: VA
authors.lastname: Onwuliri
authors.forename: Daniel Z
authors.initials: DZ
authors.lastname: Egah
authors.forename: Malcolm
authors.initials: M
authors.lastname: Potts
authors.forename: Roger V
authors.initials: RV
authors.lastname: Short
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002957:Citrus; D032082:Citrus aurantiifolia; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D006801:Humans; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D016017:Odds Ratio; D028321:Plant Preparations / Q000008:administration & dosage*; D012307:Risk Factors; D011477:Sex Work; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D011795:Surveys and Questionnaires; D044364:Vaginal Douching / Q000009:adverse effects / Q000706:statistics & numerical data*; D016387:Women's Health
chemical_list: D028321:Plant Preparations