Allahna Esber1, Abigail Norris Turner2, Gladson Mopiwa3, Alison H Norris1. 1. Division of Epidemiology, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA. 2. Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University, 410W. 10th Columbus, OH 43210, USA. 3. Child Legacy International, Umoyo wa Thanzi Research, P.O.Box 1927, Lilongwe, Malawi.
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%). CONCLUSION: 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.
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%). CONCLUSION: 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.