title: Vaginal practices of HIV-negative Zimbabwean women.
abstract: BACKGROUND
  Vaginal practices (VPs) may increase HIV risk by injuring vaginal epithelium or by increasing risk of bacterial vaginosis, an established risk factor for HIV.
  
  
  METHODS
  HIV-negative Zimbabwean women (n = 2,185) participating in a prospective study on hormonal contraception and HIV risk completed an ancillary questionnaire capturing detailed VP data at quarterly followup visits for two years.
  
  
  RESULTS
  Most participants (84%) reported ever cleansing inside the vagina, and at 40% of visits women reported drying the vagina using cloth or paper. Vaginal tightening using cloth/cotton wool, lemon juice, traditional herbs/powders, or other products was reported at 4% of visits. Women with ≥15 unprotected sex acts monthly had higher odds of cleansing (adjusted odds ratio (aOR): 1.17, 95% CI: 1.04-1.32). Women with sexually transmitted infections had higher odds of tightening (aOR: 1.42, 95% CI: 1.08-1.86).
  
  
  CONCLUSIONS
  Because certain vaginal practices were associated with other HIV risk factors, synergism between VPs and other risk factors should be explored.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University Medical Center, 410 West 10th Avenue, Doan Hall, N-11, Columbus, OH 43210, USA. ant@osumc.edu
authors.forename: Abigail Norris
authors.initials: AN
authors.lastname: Turner
authors.forename: Charles S
authors.initials: CS
authors.lastname: Morrison
authors.forename: Marshall W
authors.initials: MW
authors.lastname: Munjoma
authors.forename: Precious
authors.initials: P
authors.lastname: Moyo
authors.forename: Tsungai
authors.initials: T
authors.lastname: Chipato
authors.forename: Janneke H
authors.initials: JH
authors.lastname: van de Wijgert
mesh_terms: D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D015497:HIV-1; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D011446:Prospective Studies; D012307:Risk Factors; D014621:Vagina / Q000821:virology*; D044364:Vaginal Douching; D015030:Zimbabwe / Q000453:epidemiology