The vaginal use of herbs/substances: an HIV transmission facilitatory factor?

Heterosexual intercourse accounts for 80% of HIV transmission in sub-Saharan Africa. Factors facilitating cross-infection may include sexual practices such as the vaginal use of herbs/substances to dry, contract and heat the vagina for enhancement of sexual pleasure. The behavioural-analytic study investigated the use of different types of herbs/substances used by 75 HIV positive and 76 negative sexually active females and the perceived effects of these agents. Individual in-depth interviews were conducted. 99% of all subjects admitted using herbs/substances mainly to contract (94%), dry (58%) and heat (28%) the vagina. There was no significant difference in the pattern of use of herbs and reasons given for using the agents by HIV positive and negative women. 69% of HIV negative and 80% of positive subjects had used a mean of 4 difference types of herbs and/or substances during the last 5 years. 39% negative and 25% positive subjects had experienced intra-vaginal pain and lower abdominal pains during and after sexual intercourse, laceration of the vagina and excessive vaginal secretions after using herbs. These effects were attributed to Wankie (herb or substance) in 70% of the complaints. 14 HIV positive subjects compared with 7 in the negative group had used Wankie. The role of Wankie and similar substances in transmitting HIV cross-infection requires further investigations. From the point of view of AIDS prevention, expectations of a dry and contracted vagina in sexual intercourse may reduce acceptability and use of female and male condoms.