'Dry sex' and HIV infection among women attending a sexually transmitted diseases clinic in Lusaka, Zambia.

OBJECTIVES

To describe 'dry sex' practices intended to decrease vaginal secretions and to determine whether these practices are related to HIV infection.

SUBJECTS AND METHODS

A cross-sectional study was conducted in a sexually transmitted diseases clinic in a teaching hospital in Lusaka, Zambia. The subjects comprised 329 women aged 15-50 years presenting consecutively for an initial evaluation of sexually transmitted disease symptoms. Dry sex practices were assessed by questionnaire, and serological testing for HIV antibodies was performed.

RESULTS

Fifty percent of women had engaged in at least one dry sex practice. The most common practices were drinking 'porridge' (a liquid or suspension believed to cause drying of the vagina; 28%), removing vaginal secretions with a cloth (22%) and placing leaves in the vagina (11%). The most frequent reasons given for drinking porridge were to increase the partner's sexual enjoyment and to tighten the vagina, while cleaning the vagina was mentioned often by those using cloth or leaves. Swelling or peeling of the vagina was reported by approximately 10% of women using cloth or leaves. Overall, the HIV seroprevalence in the sample was 58%. In bivariate analysis, no practice was statistically significantly associated with HIV infection. Multiple logistic regression had little impact on these findings.

CONCLUSIONS

Although a variety of practices with potential relevance to HIV transmission were reported, there was no evidence in this study population of a strong relationship between these practices and HIV infection. Women should be counseled about the potential risks of these practices, but prevention efforts should continue to emphasize measures of known effectiveness, particularly limiting the numbers of sexual partners, consistently using condoms and obtaining appropriate treatment for sexually transmitted diseases.