Intravaginal practices among female sex workers in Kibera, Kenya.
OBJECTIVE
To assess vaginal cleansing and lubricant use among female sex workers (FSW) in Kenya participating in a 6-month, prospective study of the acceptability of the use of the diaphragm.


METHODS
The study is based on 140 FSW in Nairobi, who completed 140 baseline visits and 390 bi-monthly follow-up visits. Participants were instructed to wear the diaphragm for all coital acts during follow-up and to refrain from vaginal cleansing while wearing the diaphragm. Logistic regression was used to identify predictors of recent vaginal cleansing to 'tighten' the vagina reported at baseline; recent vaginal cleansing to prevent infection reported at baseline; recent vaginal cleansing with the diaphragm in place reported during follow-up; and recent use of oil-based lubricant during coitus reported at baseline.


RESULTS
At baseline, 99% of women reported vaginal cleansing in the previous 2 weeks for purposes of hygiene or to remove evidence of past coitus. Approximately 41% of women also reported cleansing in the past 2 weeks to 'tighten' the vagina. Women reported vaginal cleansing with the diaphragm in place in the past 2 weeks at 14% of follow-up visits in which the diaphragm was used. Predictors of such cleansing included young age, 6-month study visit, being divorced or widowed and higher educational level.


CONCLUSIONS
While vaginal cleansing is a modifiable behaviour, given that cleansing for hygiene was almost universal among this study population at baseline and that more women reported cleansing while wearing the diaphragm as the study progressed, the complete eradication of the practice would probably be difficult.
Gallo
Maria F
MF
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA. mgallo@cdc.gov
Sharma
Anjali
A
Bukusi
Elizabeth A
EA
Njoroge
Betty
B
Nguti
Rosemary
R
Jamieson
Denise J
DJ
Bell
April J
AJ
Eschenbach
David A
DA
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D006920:Hygiene; D007434:Intrauterine Devices / Q000706:statistics & numerical data*; D007630:Kenya; D008875:Middle Aged; D017060:Patient Satisfaction; D011477:Sex Work / Q000706:statistics & numerical data*; D014622:Vaginal Creams, Foams, and Jellies / Q000627:therapeutic use; D044364:Vaginal Douching / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
D014622:Vaginal Creams, Foams, and Jellies