Intravaginal Practices and Prevalence of Sexual and Reproductive Tract Infections Among Women in Rural Malawi.
Many women engage in intravaginal practices (IVP) with a goal of improving genital hygiene and increasing sexual pleasure. Intravaginal practices can disrupt the genital mucosa, and some studies have found that IVP increases risk of acquisition of HIV and bacterial vaginosis (BV). Limited prior research also suggests significant associations between IVP, herpes simplex virus type 2 (HSV-2), and high-risk types of human papillomavirus (HPV).



We examined associations between IVP and HPV, BV, and HSV-2 among 200 women in rural Malawi participating in a clinic-based study on sexual and reproductive tract infections. We calculated prevalence ratios for the associations between frequency and type of IVP and outcomes of HPV, BV, and HSV-2.



Intravaginal practices were commonly performed, with 95% of women reporting current use of at least 1 practice. Infections were also frequently detected: Twenty-two percent of the sample had at least 1 high-risk HPV type, 51% had BV, and 50% were HSV-2 seropositive. We observed no significant associations between type of IVP, frequency of IVP, or a combined measure capturing type and frequency of IVP-and any of the infection outcomes.



Although both IVP and our outcomes of interest (BV, HPV, and HSV-2) were common in the study population, we did not detect associations between IVP type or frequency and any of the 3 infections. However, the high prevalence and frequency of IVP may have limited our ability to detect significant associations.
From the *Division of Epidemiology, †College of Medicine, The Ohio State University, Columbus, OH; ‡The George Washington University School of Medicine and Health Sciences, Washington, DC; §Child Legacy International, Umoyo wa Thanzi Research, Lilongwe Malawi; and ¶Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University, Columbus, OH.
Allahna
A
Esber
Nisha
N
Rao
Alison
A
Norris
Patricia
P
Carr Reese
Jonathan
J
Kandodo
Patrick
P
Nampandeni
Enock
E
Jumbe
Abigail
A
Norris Turner
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006558:Herpes Genitalis / Q000453:epidemiology* / Q000821:virology; D018258:Herpesvirus 2, Human / Q000302:isolation & purification; D006801:Humans; D008295:Malawi / Q000453:epidemiology; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D060737:Reproductive Tract Infections / Q000453:epidemiology* / Q000382:microbiology; D044364:Vaginal Douching / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D016585:Vaginosis, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult