Intravaginal practices are associated with acquiring HIV infection

February 15, 2011

Although there is no evidence to suggest a direct causal pathway, some intravaginal practices used by women in sub-Saharan Africa (such as washing the vagina with soap) may increase the acquisition of HIV infection and so should be avoided. Encouraging women to use less harmful intravaginal practices (for example, washing with water alone) should therefore be included in female-initiated HIV prevention research strategies in sub-Saharan Africa. These are the key findings from a study by Nicola Low, from the University of Bern, Bern, Switzerland, and colleagues and published in this week's PLoS Medicine.

The authors pooled individual participant data from 13 prospective cohort studies in sub-Saharan Africa involving nearly 15,000 women, 791 of whom acquired HIV, and found that within two years of enrolment in the studies was associated with self-reported intravaginal practices. After controlling for age, , and the number of recent sex partners, women who used cloth or paper to clean their vagina were nearly one and half times more likely to have acquired HIV infection as women who did not use this practice. Furthermore, the insertion of products to dry or tighten the vagina and intravaginal cleaning with soap also increased women's chances of acquiring HIV. Intravaginal cleaning with soap was associated with the development of , and disrupted vaginal flora—two conditions associated with an increased risk of HIV acquisition.

These findings add to the results of a recent systematic review, published in PLoS ONE, which suggested that a pathway linking intravaginal cleaning practices with vaginal infections that increase susceptibility to HIV infection is plausible, but conclusive evidence is lacking.

The authors of the study say: "New female-initiated interventions also need to be developed despite the challenges involved in measuring the impact on preventing acquisition. Behavioural interventions that have been successful in helping young US women to stop vaginal douching might be adapted for women in sub-Saharan Africa to encourage less harmful practices."

More information: Low N, Chersich MF, Schmidlin K, Egger M, Francis SC, et al. (2011) Intravaginal Practices, Bacterial Vaginosis, and HIV Infection in Women: Individual Participant Data Meta-analysis. PLoS Med 8(2): e1000416. doi:10.1371/journal.pmed.1000416

Related Stories

Recommended for you

Study suggests a way to stop HIV in its tracks

December 1, 2017
When HIV-1 infects an immune cell, the virus travels to the nucleus so quickly there's not enough time to set off the cell's alarm system.

Discovery puts the brakes on HIV's ability to infect

November 30, 2017
Viewed with a microscope, the virus faintly resembles a pineapple—the universal symbol of welcome. But HIV, the virus that causes AIDS, is anything but that. It has claimed the lives of more than 35 million people so far.

Rising levels of HIV drug resistance

November 30, 2017
HIV drug resistance is approaching and exceeding 10% in people living with HIV who are about to initiate or reinitiate first-line antiretroviral therapy, according to the largest meta-analysis to date on HIV drug resistance, ...

Male circumcision and antiviral drugs appear to sharply reduce HIV infection rate

November 29, 2017
A steep drop in the local incidence of new HIV infections accompanied the rollout of a U.S.-funded anti-HIV program in a large East-African population, according to a study led by researchers at Johns Hopkins Bloomberg School ...

Combination HIV prevention reduces new infections by 42 percent in Ugandan district

November 29, 2017
A study published today in the New England Journal of Medicine provides real-world evidence that implementing a combination of proven HIV prevention measures across communities can substantially reduce new HIV infections ...

Research on HIV viral load urges updates to WHO therapy guidelines

November 24, 2017
A large cohort study in South Africa has revealed that that low-level viraemia (LLV) in HIV-positive patients who are receiving antiretroviral treatment (ART) is an important risk factor for treatment failure.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.