Maternal, Adolescent and Child Health, Department of Obstetrics and Gynaecology, University of the Witwatersrand, Durban, South Africa.
Trop Med Int Health. 2011 Feb;16(2):245-56. doi: 10.1111/j.1365-3156.2010.02687.x. Epub 2010 Nov 23.
To investigate population-level prevalence of vaginal practices, their frequency and self-reported health consequences in KwaZulu-Natal, South Africa.
A household survey using multi-stage cluster sampling was conducted in 2007. Women aged 18-60 (n = 867) were interviewed on demographics, sexual behaviours and vaginal practices, focusing on intravaginal practices. Design-based analysis used multivariate logistic regression to identify factors associated with intravaginal or any practice.
Most women currently perform vaginal practices (90.2%), with 34.8% reporting two and 16.3%≥3 practices. Internal cleansing, the commonest practice (63.3% of women), is undertaken frequently (61.6% cleansing twice daily; 20.0% using ≥2 products). Fewer report application (10.1%), insertion (11.6%) or ingestion (14.3%) practices. Hygiene is a common motivation, even for the 23.2% of women reporting intravaginal practices around the time of sex. Prevalence of any practice was lower among women with tertiary education than those without primary education (AOR = 0.26, 95% CI = 0.08-0.85), nearly twice as common in sexually active women (95% CI = 1.05-3.56) and increased as overall health status declined. Adjusted odds of intravaginal practices were 1.8-fold higher in women reporting unprotected sex (95% CI = 1.11-2.90). Few reported health problems with current practices (0.6%); though, 12.6% had ever-experienced adverse effects.
Vaginal practices are common in KwaZulu-Natal. Although self-reported health problems with current practices are rare, high lifetime risk of adverse events and potential for asymptomatic but clinically important damage make continued research important.
调查南非夸祖鲁-纳塔尔省人群阴道操作的流行率、频率及其自我报告的健康后果。
2007 年采用多阶段聚类抽样方法进行了一项家庭调查。对年龄在 18-60 岁的女性（n=867）进行了人口统计学、性行为和阴道操作方面的访谈，重点关注阴道内操作。基于设计的分析采用多变量逻辑回归来确定与阴道内或任何操作相关的因素。
大多数女性目前进行阴道操作（90.2%），其中 34.8%报告了两种操作，16.3%的女性进行了≥3 种操作。内部清洁是最常见的操作（63.3%的女性），且频率较高（61.6%的女性每天清洁两次；20.0%的女性使用≥2 种产品）。较少的女性报告应用（10.1%）、插入（11.6%）或摄入（14.3%）操作。即使在 23.2%的女性报告在性行为时进行阴道内操作的情况下，卫生也是常见的动机。与没有小学教育的女性相比，具有高等教育的女性进行任何操作的比例较低（AOR=0.26，95%CI=0.08-0.85），在性活跃的女性中更为常见（95%CI=1.05-3.56），并且随着整体健康状况的下降而增加。报告无保护性行为的女性进行阴道内操作的调整后优势比为 1.8 倍（95%CI=1.11-2.90）。很少有女性报告当前操作存在健康问题（0.6%）；尽管如此，仍有 12.6%的女性曾经历过不良反应。
在夸祖鲁-纳塔尔省，阴道操作很常见。尽管目前操作很少有自我报告的健康问题，但终身不良事件的高风险以及无症状但具有临床重要性的损害的潜在风险，使得持续进行研究非常重要。
