title: Vaginal practices and associations with barrier methods and gel use among Sub-Saharan African women enrolled in an HIV prevention trial.
abstract: Vaginal practices may interfere with the use and/or the effectiveness of female-initiated prevention methods. We investigated whether vaginal practices differed by randomization group in a phase III trial of the diaphragm with lubricant gel (MIRA) in Sub-Saharan Africa (n = 4925), and if they were associated with consistent use of study methods. At baseline, vaginal practices were commonly reported: vaginal washing (82.77%), wiping (56.47%) and insertion of dry or absorbent materials (20.58%). All three practices decreased during the trial. However, women in the intervention group were significantly more likely to report washing or wiping during follow-up compared to those in the control group. Additionally, washing, wiping, and insertion, were all independently and inversely associated with consistent diaphragm and gel use and with condom use as well, regardless of study arm. A better understanding of the socio-cultural context in which these practices are embedded could improve educational strategies to address these potentially modifiable behaviors, and may benefit future HIV prevention interventions of vaginal methods.
authors.affiliation: Women's Global Health Imperative, RTI International, 114 Sansome Street, Suite 500, San Francisco, CA 94104, USA. ariane@rti.org
authors.forename: Ariane
authors.initials: A
authors.lastname: van der Straten
authors.forename: Helen
authors.initials: H
authors.lastname: Cheng
authors.forename: Agnes
authors.initials: A
authors.lastname: Chidanyika
authors.forename: Guy
authors.initials: G
authors.lastname: De Bruyn
authors.forename: Nancy
authors.initials: N
authors.lastname: Padian
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D017954:Africa South of the Sahara; D017280:Condoms / Q000706:statistics & numerical data*; D003274:Contraceptive Devices, Female / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D015497:HIV-1; D006801:Humans; D011247:Pregnancy; D016896:Treatment Outcome; D014622:Vaginal Creams, Foams, and Jellies / Q000008:administration & dosage*; D044364:Vaginal Douching / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D014622:Vaginal Creams, Foams, and Jellies