title: Vaginal douching and sexually transmitted infections among female sex workers: a cross-sectional study in three provinces in China.
abstract: Though vaginal douching is a common practice among female sex workers that could increase the risk of HIV and adverse reproductive health outcomes, it has drawn limited attention. From November 2010 to January 2011, a convenience sample of female sex workers was recruited in three cities in China. Face-to-face interviews were conducted to gather socio-demographic and behavioural information. Blood samples were collected for syphilis serological tests. Endo-cervical swabs were collected and tested for Neisseria gonorrhoeae and Chlamydia trachomatis by polymerase chain reaction. A logistic regression model was used to determine factors associated with vaginal douching and the association between vaginal douching and sexually transmitted infection. A total of 1032 eligible female sex workers were enrolled. The overall prevalence of any sexually transmitted infection (syphilis, Chlamydia trachomatis or Neisseria gonorrhoeae) and vaginal douching with disinfectant were 23.4% and 23.1%, respectively. Factors independently associated with douching practice included study sites, venue types, ethnicity, having regular partner and sexually transmitted infection history. No significant association was found between vaginal douching and current sexually transmitted infection. Vaginal douching with disinfectant after sex with clients seemed to be a prevalent practice among female sex workers in China. Prevention programmes targeting female sex workers should incorporate components about the adverse health outcomes associated with vaginal douching.
authors.affiliation: National Center for STD Control, Chinese Academy of Medical Sciences and Peiking Union Medical College, Institute of Dermatology, Nanjing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: National Center for STD Control, Chinese Academy of Medical Sciences and Peiking Union Medical College, Institute of Dermatology, Nanjing, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Jiang
authors.affiliation: National Center for STD Control, Chinese Academy of Medical Sciences and Peiking Union Medical College, Institute of Dermatology, Nanjing, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Yue
authors.affiliation: National Center for STD Control, Chinese Academy of Medical Sciences and Peiking Union Medical College, Institute of Dermatology, Nanjing, China gxdchina@163.com.
authors.forename: Xiangdong
authors.initials: X
authors.lastname: Gong
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D002690:Chlamydia Infections / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D011159:Population Surveillance; D015995:Prevalence; D012309:Risk-Taking; D011477:Sex Work; D060386:Sex Workers / Q000706:statistics & numerical data*; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000517:prevention & control; D012959:Socioeconomic Factors; D013587:Syphilis / Q000453:epidemiology; D044364:Vaginal Douching
keywords: China; Chlamydia trachomatis; Neisseria gonorrhoeae; Vaginal douching; female sex workers; sexually transmitted infection