title: Vaginal douching and association with sexually transmitted infections among female sex workers in a prefecture of Yunnan Province, China.
abstract: Vaginal douching is a common practice and has been hypothesised to increase a woman's risk for human of contracting HIV and sexually transmitted infections (STIs). Our objective was to assess the prevalence of douching and its association with STIs, genital symptoms and HIV/STI knowledge among female sex workers (FSWs). We conducted a cross-sectional study of 837 FSWs with interviews and laboratory tests for HIV/STIs in a prefecture of Yunnan Province in southern China. Vaginal douching was reported by 84% of the women. We found a higher prevalence of vaginal douching practice among FSWs of Han ethnicity, and who were single or cohabitating. Douching was also significantly more common among more educated FSWs and those with greater knowledge of HIV/STIs, and as well as in FSWs who had experienced clinical symptoms in the previous 12 months. Douching was linked to higher risks of HIV (adjusted odds ratio = 2.29; 95% confidence interval 1.01-5.23) and herpes simplex virus type 2 infections (adjusted odds ratio = 2.18; 95% confidence interval 1.46-3.24) after adjusting for confounding factors. Medical professionals and public health workers should correct women's misconception about the effectiveness of douching and discourage women from douching through educational activities. More prospective studies among FSWs are urgently required to identify the relationship between vaginal douching and HIV/STIs.
authors.affiliation: Chinese Center for Disease Control and Prevention, Beijing, PR China.
authors.forename: Li
authors.initials: L
authors.lastname: Luo
authors.affiliation: Key Laboratory of Immunology of AIDS, Ministry of Health, First Affiliated Hospital, China Medical University, Shenyang, PR China.
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Xu
authors.affiliation: Kaiyuan Center for Disease Control and Prevention, Yunnan, PR China.
authors.forename: Gui-Xiang
authors.initials: GX
authors.lastname: Wang
authors.affiliation: National Center for AIDS/STD Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing, PR China.
authors.forename: Guo-Wei
authors.initials: GW
authors.lastname: Ding
authors.affiliation: National Center for AIDS/STD Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing, PR China.
authors.forename: Ning
authors.initials: N
authors.lastname: Wang
authors.affiliation: Peking University Clinical Research Institute, Beijing, PR China hbwang2005@163.com wangnbj@163.com.
authors.forename: Hai-Bo
authors.initials: HB
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D011477:Sex Work; D060386:Sex Workers; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000635:transmission; D007507:Therapeutic Irrigation / Q000009:adverse effects*; D044364:Vaginal Douching / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: China; Vaginal douching; female sex workers; human immunodeficiency virus; sexually transmitted infections