Esber Allahna, Moyo Precious, Munjoma Marshall, Francis Shelley, van de Wijgert Janneke, Chipato Tsungai, Turner Abigail Norris
Division of Epidemiology, The Ohio State University, Columbus, Ohio, USA.
UZ-UCSF Collaborative Research Programme, Harare, Zimbabwe.
Sex Transm Infect. 2015 May;91(3):183-8. doi: 10.1136/sextrans-2014-051764. Epub 2014 Oct 29.
Intravaginal practices--including behaviours such as washing with soap or other materials, using fingers or cloth, or insertion of herbs, powders or other products to dry, cleanse or 'tighten' the vagina--may increase women's risk of bacterial vaginosis by disrupting the vaginal microbiota. In Zimbabwe, intravaginal practices are common. The objective of this study was to assess the feasibility of an intervention based on the transtheoretical model of behaviour change (also called the 'stages of change' model) to encourage cessation of vaginal practices among a sample of Zimbabwean women.
We conducted a 12-week behaviour change intervention to encourage cessation of intravaginal practices (other than cleansing with water) among 85 Zimbabwean women who reported these practices.
Self-reported intravaginal practices declined significantly over follow-up, with 100% of women reporting at least one intravaginal practice at enrolment compared with 8% at the final visit. However, we found no significant effect of this reduction on bacterial vaginosis prevalence in unadjusted or adjusted multivariable models (adjusted prevalence ratio for any practice vs none: 0.94, 95% CI 0.61 to 1.43).
While the intervention was successful in reducing women's self-reported engagement in intravaginal practices, we observed no corresponding benefit to vaginal health.
阴道内操作——包括用肥皂或其他材料清洗、使用手指或布、插入草药、粉末或其他产品来干燥、清洁或“收紧”阴道等行为——可能会破坏阴道微生物群，从而增加女性患细菌性阴道病的风险。在津巴布韦，阴道内操作很常见。本研究的目的是评估基于行为改变跨理论模型（也称为“改变阶段”模型）的干预措施在津巴布韦女性样本中鼓励停止阴道内操作的可行性。
我们对85名报告有此类操作的津巴布韦女性进行了为期12周的行为改变干预，以鼓励她们停止（除用水清洁外的）阴道内操作。
在随访期间，自我报告的阴道内操作显著减少，入组时100%的女性报告至少有一种阴道内操作，而在最后一次随访时这一比例为8%。然而，在未调整或调整后的多变量模型中，我们发现这种减少对细菌性阴道病患病率没有显著影响（有任何操作与无操作的调整患病率比：0.94，95%可信区间0.61至1.43）。
虽然干预措施成功减少了女性自我报告的阴道内操作行为，但我们并未观察到对阴道健康有相应益处。
