University of California and the AIDS Research Alliance of America, Los Angeles, and the University of California, San Francisco, San Francisco, California.
Obstet Gynecol. 2013 Apr;121(4):773-780. doi: 10.1097/AOG.0b013e31828786f8.
To measure intravaginal practices among women of differing ages, ethnicities, and human immunodeficiency virus status and the association between intravaginal practices and bacterial vaginosis and candidiasis infection.
Between 2008 and 2010, we recruited and followed sexually active women aged 18-65 years living in Los Angeles. At the enrollment and month 12 visit, participants completed a self-administered, computer-assisted questionnaire covering demographics, sexual behaviors, vaginal symptoms, and intravaginal practices over the past month. At each visit, bacterial vaginosis and candidiasis infection were diagnosed by Nugent criteria and DNA probe, respectively.
We enrolled 141 women. Two thirds (66%) reported an intravaginal practice over the past month; 49% reported insertion of an intravaginal product (other than tampons) and 45% reported intravaginal washing. The most commonly reported practices included insertion of commercial sexual lubricants (70%), petroleum jelly (17%), and oils (13%). In univariable analysis, intravaginal use of oils was associated with Candida species colonization (44.4% compared with 5%, P<.01). In multivariable analysis, women reporting intravaginal use of petroleum jelly over the past month were 2.2 times more likely to test positive for bacterial vaginosis (adjusted relative risk 2.2, 95% confidence interval 1.3-3.9).
Intravaginal insertion of over-the-counter products is common among women in the United States and is associated with increased risk of bacterial vaginosis. The context, motivations for, and effects of intravaginal products and practices on vaginal health are of concern and warrant further study.
III.
测量不同年龄、种族和人类免疫缺陷病毒（HIV）状态的女性的阴道内操作，并评估阴道内操作与细菌性阴道病和念珠菌感染之间的关联。
2008 年至 2010 年，我们招募并随访了居住在洛杉矶的 18-65 岁有性行为的女性。在入组时和第 12 个月访视时，参与者完成了一份自我管理的计算机辅助问卷，内容包括人口统计学、性行为、阴道症状以及过去一个月的阴道内操作。在每次访视时，均通过 Nugent 标准和 DNA 探针诊断细菌性阴道病和念珠菌感染。
我们共招募了 141 名女性。三分之二（66%）的女性报告过去一个月有阴道内操作；49%的女性报告插入阴道内产品（除了卫生棉条），45%的女性报告阴道冲洗。最常报告的操作包括插入商业性阴道润滑剂（70%）、凡士林（17%）和油类（13%）。单变量分析显示，阴道内使用油类与念珠菌属定植有关（44.4%比 5%，P<.01）。多变量分析显示，过去一个月报告阴道内使用凡士林的女性，细菌性阴道病检测阳性的可能性是未使用者的 2.2 倍（调整后的相对风险 2.2，95%置信区间 1.3-3.9）。
在美国女性中，使用非处方产品进行阴道内插入是常见的，并且与细菌性阴道病风险增加有关。阴道内产品和操作的背景、动机及其对阴道健康的影响令人关注，需要进一步研究。
III 级。
