title: Intravaginal practices among HIV-negative female sex workers along the US-Mexico border and their implications for emerging HIV prevention interventions.
abstract: OBJECTIVE
  To describe intravaginal practices (IVPs) among female sex workers (FSWs) who inject drugs in two cities-Tijuana and Ciudad Juarez-on the border between the USA and Mexico.
  
  
  METHODS
  Data for a secondary analysis were obtained from interviews conducted as part of a randomized controlled trial in FSWs who injected drugs between October 28, 2008, and May 31, 2010. Eligible individuals were aged at least 18years and reported sharing injection equipment and having unprotected sex with clients in the previous month. Descriptive statistics were used to assess frequency and type of IVPs. Logistic regression was used to assess correlates of IVPs.
  
  
  RESULTS
  Among 529 FSWs who completed both surveys, 229 (43.3%) had performed IVPs in the previous 6months. Factors independently associated with IVPs were reporting any sexually transmitted infection in the previous 6months (adjusted odds ratio [aOR] 1.8, 95% confidence interval [CI] 1.1-3.1; P=0.03), three or more pregnancies (aOR 1.9, 95% CI 1.1-3.2; P=0.02), and having clients who became violent when proposing condom use (aOR 5.8, 95% CI 1.0-34.3; P=0.05), which are all factors related to inconsistent condom use.
  
  
  CONCLUSIONS
  Screening for IVPs could help to identify FSW at increased risk of HIV, and facilitate conversations about specific risk-reduction methods.
authors.affiliation: Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Dominika
authors.initials: D
authors.lastname: Seidman
authors.affiliation: Population Health and Epidemiology, Island Health, Victoria, BC, Canada; School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada.
authors.forename: Melanie
authors.initials: M
authors.lastname: Rusch
authors.affiliation: Division of Global Public Health, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Daniela
authors.initials: D
authors.lastname: Abramovitz
authors.affiliation: Division of Global Public Health, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Jamila K
authors.initials: JK
authors.lastname: Stockman
authors.affiliation: Community Health and Development of Ciudad Juarez and the Mexican Federation of Private Associations, Ciudad Juarez, Mexico.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Martinez
authors.affiliation: El Colegio de la Frontera del Norte, Tijuana, Mexico.
authors.forename: Gudelia
authors.initials: G
authors.lastname: Rangel
authors.affiliation: Division of Global Public Health, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Alicia
authors.initials: A
authors.lastname: Vera
authors.affiliation: Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Monica D
authors.initials: MD
authors.lastname: Ulibarri
authors.affiliation: Division of Global Public Health, University of California, San Diego, La Jolla, CA, USA. Electronic address: sstrathdee@ucsd.edu.
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D055030:Drug Users / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D016015:Logistic Models; D008800:Mexico; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D012309:Risk-Taking; D060386:Sex Workers / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D044364:Vaginal Douching / Q000706:statistics & numerical data*
keywords: Douching; Female sex workers; HIV risk; Intravaginal practices