Tsai Cynthia S, Shepherd Bryan E, Vermund Sten H
Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN, USA.
Am J Obstet Gynecol. 2009 Jan;200(1):38.e1-8. doi: 10.1016/j.ajog.2008.06.026. Epub 2008 Jul 30.
The objective of the study was to examine the association between douching and 4 sexually transmitted infections (STIs).
We followed up 411 high-risk human immunodeficiency virus-infected and uninfected female adolescents aged 12-19 years over a median 3-year period, both by time from study entry/first STI-free visit until an incident STI for participants who never, intermittently, and always douched and also by reported douching at a given STI-free visit and incidence of STI at the next visit, using adjusted Cox proportional hazards models to calculate hazard ratios (HR).
The time to STI was shorter for adolescents who always (HR, 2.1; 95% confidence interval [CI], 1.2-3.4) and intermittently (HR, 1.5; 95% CI, 1.0-2.2) douched, compared with never-douchers. An adjusted hazard for STI was 1.8 times larger for always-douchers (95% CI, 1.1-3.1) and 1.4 times larger for intermittent douchers (95% CI, 0.9-2.0), compared with never-douchers. When classifying by follow-up after an STI-free visit, always-douchers had a shorter STI-free time than never-douchers (HR(adj), 2.1; 95% CI, 1.5-3.1).
Counseling to discourage douching may reduce STI risk in adolescents.
本研究的目的是检验阴道灌洗与4种性传播感染(STIs)之间的关联。
我们对411名年龄在12至19岁之间的高危人类免疫缺陷病毒感染和未感染的女性青少年进行了为期3年的随访,随访时间从研究入组/首次无STI访视开始,直至从未、间断和经常进行阴道灌洗的参与者发生STI,同时也根据在特定无STI访视时报告的阴道灌洗情况以及下次访视时的STI发病率,使用校正后的Cox比例风险模型计算风险比(HR)。
与从不进行阴道灌洗的青少年相比,经常(HR,2.1;95%置信区间[CI],1.2 - 3.4)和间断(HR,1.5;95% CI,1.0 - 2.2)进行阴道灌洗的青少年发生STI的时间更短。与从不进行阴道灌洗者相比,经常进行阴道灌洗者发生STI的校正风险高1.8倍(95% CI,1.1 - 3.1),间断进行阴道灌洗者高1.4倍(95% CI,0.9 - 2.0)。在无STI访视后的随访分类中,经常进行阴道灌洗者的无STI时间比从不进行阴道灌洗者短(校正后HR,2.1;95% CI,1.5 - 3.1)。
提供劝阻阴道灌洗的咨询可能会降低青少年感染STI的风险。