Associations Between Intravaginal Practices and Bacterial Vaginosis in Kenyan Female Sex Workers Without Symptoms of Vaginal Infections

Abstract

Background: Bacterial vaginosis (BV) is highly prevalent among African women and has been associated with adverse pregnancy outcomes, sexually transmitted diseases, and HIV-1. Goal: The goal of this study was to analyze the relationship among intravaginal practices, bathing, and BV. Study Design: The authors conducted a cross-sectional study of HIV-1-seronegative Kenyan female sex workers without symptoms of vaginal infections. Results: Of 237 women enrolled, 206 (87%) reported vaginal washing using either a finger or cloth. Increasing frequency of vaginal washing was associated with a higher likelihood of BV (χ² test for trend, P = 0.05). In multivariate analysis, vaginal lubrication with petroleum jelly (odds ratio [OR] = 2.8, 95% confidence interval [CI] = 1.4–5.6), lubrication with saliva (OR = 2.3, 95% CI = 1.1–4.8), and bathing less than the median for the cohort (14 times/week; OR = 4.6, 95% CI = 1.2–17.5) were associated with a significantly higher likelihood of BV. Conclusions: Modification of intravaginal and general hygiene practices should be evaluated as potential strategies for reducing the risk of BV.