title: Intravaginal practices among a cohort of rural Malawian women.
abstract: BACKGROUND
  Intravaginal practices (IVP) are highly prevalent and commonly performed in many countries for a variety of purposes related to genital health, hygiene and sexual pleasure. However, IVP may also have harmful side effects, including associations with bacterial vaginosis and HIV.
  
  
  METHODS
  The prevalence and motivations for IVP among 650 women participating in the baseline survey of a community-based cohort study on sexual and reproductive health in rural Lilongwe District, Malawi, were characterised. Key variables included the type and frequency of IVP, and motivations for engaging in IVP.
  
  
  RESULTS
  Most women (95%) had engaged in IVP in the past 30 days: 88% reported internal vaginal cleansing with water only, 87% reported cleansing with soap and water, and 84% reported inserting cotton, cloth or tissue. A majority (60%) reported at least three practices. Very frequent engagement in at least one type of IVP was also common; among those who inserted cotton, cloth or tissue, 43% did so more than once a day; among those who cleansed internally with soap and water, 51% did so more than once a day. Women reported many reasons for using IVP. The most commonly reported reasons were to remove odours (91%), to remove extra moisture (58%), to prevent disease (49%), to relieve symptoms of disease (41%) and to improve sex for a partner (40%).
  
  
  CONCLUSIONS
  IVP are highly prevalent and frequently performed among these rural Malawian women. Future research should investigate the associations between IVP and sexually transmissible infection prevalence.
authors.affiliation: Division of Epidemiology, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA.
authors.forename: Allahna
authors.initials: A
authors.lastname: Esber
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University, 410W. 10th Columbus, OH 43210, USA.
authors.forename: Abigail Norris
authors.initials: AN
authors.lastname: Turner
authors.affiliation: Child Legacy International, Umoyo wa Thanzi Research, P.O.Box 1927, Lilongwe, Malawi.
authors.forename: Gladson
authors.initials: G
authors.lastname: Mopiwa
authors.affiliation: Division of Epidemiology, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA.
authors.forename: Alison H
authors.initials: AH
authors.lastname: Norris
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections; D006801:Humans; D006920:Hygiene; D012725:Sexual Behavior; D012747:Sexual Partners; D014621:Vagina; D016585:Vaginosis, Bacterial