Chisembele Maureen, Rodriguez Violeta J, Brown Megan R, Jones Deborah L, Alcaide Maria L
1 Department of Obstetrics and Gynecology, University of Zambia, Lusaka, Zambia.
2 Department of Psychiatry and Behavioral Sciences, 5452 University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Int J STD AIDS. 2018 Feb;29(2):164-171. doi: 10.1177/0956462417721438. Epub 2017 Jul 12.
Intravaginal practices (IVP) are linked to bacterial vaginosis (BV), obstetric/gynecological complications, and HIV. Late adolescent and young adult (LAYA) women in Zambia have high rates of HIV. Adult and mature (AM) HIV-infected women in Zambia engage in IVP for hygiene, health, and sexuality reasons; however, to our knowledge, IVP use among LAYA women has not been examined. This study compares IVP use between LAYA and AM women to identify age-specific factors to target when developing IVP reduction interventions for LAYA women. LAYA (≤25 years; n = 24) and AM (>25 years; n=124) HIV-infected women completed self-administered demographic, HIV history, sexual risk factor, and IVP measures. LAYA and AM women were then compared. Number of sexual partners, sexual activity, or condom use did not differ between groups. Rates of IVP in the prior month with different products were similar, though LAYA women used soap more frequently (96% versus 74.2%, p = 0.034). LAYA women were more likely to use products for hygiene reasons (soap 83% versus 43%; cloth, paper, or wipes 50% versus 17%, p < 0.05); and AM women to use products to please sexual partners (cloth 20% versus 56%, p = 0.074). Interventions tailored to LAYA women may be needed to reduce IVP and subsequent BV as LAYA women may have different reasons for engaging in IVP, in comparison with AM women. Reduced IVP among LAYA women may decrease the risk for HIV transmission to sexual partners and newborns and is urgently needed in settings with high prevalence of IVP, BV, and HIV infections, such as Zambia.
阴道内操作（IVP）与细菌性阴道病（BV）、妇产科并发症及艾滋病病毒（HIV）感染相关。赞比亚的青少年晚期及青年成年（LAYA）女性感染HIV的比例较高。赞比亚成年及成熟（AM）的HIV感染女性出于卫生、健康及性方面的原因进行阴道内操作；然而，据我们所知，尚未对LAYA女性使用IVP的情况进行研究。本研究比较了LAYA女性和AM女性使用IVP的情况，以确定在制定针对LAYA女性减少IVP的干预措施时需要关注的特定年龄因素。年龄≤25岁的LAYA女性（n = 24）和年龄>25岁的AM女性（n = 124）完成了自行填写的人口统计学、HIV感染史、性风险因素及IVP相关测量。随后对LAYA女性和AM女性进行了比较。两组之间的性伴侣数量、性活动或避孕套使用情况并无差异。尽管LAYA女性更频繁地使用肥皂进行IVP（96%对74.2%，p = 0.034），但前一个月使用不同产品进行IVP的比例相似。LAYA女性更有可能出于卫生原因使用产品（肥皂83%对43%；布、纸或湿巾50%对17%，p < 0.05）；而AM女性更倾向于使用产品取悦性伴侣（布20%对56%，p = 0.074）。可能需要针对LAYA女性制定专门的干预措施以减少IVP及后续的BV，因为与AM女性相比，LAYA女性进行IVP的原因可能不同。减少LAYA女性的IVP使用可能会降低HIV传播给性伴侣和新生儿的风险，在赞比亚这种IVP、BV及HIV感染高发的地区，这一需求尤为迫切。
