title: Beyond douching: use of feminine hygiene products and STI risk among young women.
abstract: BACKGROUND
  Use of feminine hygiene products (feminine wipes, sprays, douches, and yeast creams) by adolescent women is common, yet understudied.
  
  
  OBJECTIVE
  We examine the association among these genital hygiene behaviors, condom use, and sexually transmitted infection (STI).
  
  
  METHODS
  Using the interview as our unit of analysis, we examined associations between genital hygiene behaviors (use of feminine wipes, feminine sprays, douches, or yeast creams), STI risk factors, and infection with Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis.
  
  
  METHODS
  We recruited 295 adolescent women from primary care clinics as part of a larger longitudinal study of STI among high-risk adolescents. Participants completed face-to-face interviews every 3 months, and provided vaginal swabs for STI testing. Data were analyzed with repeated measures logistic models to control for multiple observations contributed by each participant.
  
  
  RESULTS
  Participants reported douching in 25% of interviews, feminine sprays in 29%, feminine wipes in 27%, and yeast creams in 19% of interviews. We observed a co-occurrence of douching, spraying, and wiping. A past STI (6 months or more prior) was associated with increased likelihood of yeast cream use, and a recent STI (3 months prior) was associated with increased likelihood of feminine wipe use. Condom use was modestly associated with increased likelihood of douching.
  
  
  CONCLUSIONS
  Young women frequently use feminine hygiene products, and it is important for clinicians to inquire about use as these products may mimic or mask STI. We found no associations between douching and STI, but instead modest associations between hygiene and STI prevention, suggesting motivation for self-care.
authors.affiliation: Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine 410 West 10th Street, HS 1001, Indianapolis, Indiana 46202, USA. maott@iupui.edu
authors.forename: Mary A
authors.initials: MA
authors.lastname: Ott
authors.forename: Susan
authors.initials: S
authors.lastname: Ofner
authors.forename: J Dennis
authors.initials: JD
authors.lastname: Fortenberry
mesh_terms: D000293:Adolescent; D000818:Animals; D002690:Chlamydia Infections / Q000209:etiology*; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D017280:Condoms / Q000009:adverse effects; D005260:Female; D053566:Hygiene Products / Q000009:adverse effects*; D006069:Gonorrhea / Q000209:etiology*; D006801:Humans; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000209:etiology*; D014247:Trichomonas Vaginitis / Q000209:etiology*; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D055815:Young Adult