Effective intervention to reduce intravaginal practices among hiv-1 uninfected Kenyan women.
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Date
2014Author
Sivapalasingam, Sumathi
McClelland, R. Scott
Jacques, Ravel
Aabid, Ahmed
Charles, M. Cleland
Pawel, Gajer
Musa, Mwamzaka
Fatma, Marshed
Juma, Shafi,
Linnet, Masese
Mark, Fajans
Molly, E. Anderson
Jaoko, Walter
Kurth, Ann E
Language
enMetadata
Show full item recordAbstract
Intravaginal practices (IVP) are common among African women and are associated with HIV acquisition. A behavioral intervention to reduce IVP is a potential new HIV risk-reduction strategy. Fifty-eight HIV-1-uninfected Kenyan women reporting IVP and 42 women who denied IVP were followed for 3 months. Women using IVP attended a skill-building, theory-based group intervention occurring weekly for 3 weeks to encourage IVP cessation. Vaginal swabs at each visit were used to detect yeast, to detect bacterial vaginosis, and to characterize the vaginal microbiota. Intravaginal insertion of soapy water (59%) and lemon juice (45%) was most common among 58 IVP women. The group-counseling intervention led to a decrease in IVP from 95% (54/58) at baseline to 0% (0/39) at month 3 (p=0.001). After 3 months of cessation, there was a reduction in yeast on vaginal wet preparation (22% to 7%, p=0.011). Women in the IVP group were more likely to have a Lactobacillus iners-dominated vaginal microbiota at baseline compared to controls [odds ratio (OR), 6.4, p=0.006] without significant change in the microbiota after IVP cessation. The group counseling intervention was effective in reducing IVP for 3 months. Reducing IVP may be important in itself, as well as to support effective use of vaginal microbicides, to prevent HIV acquisition.
Citation
Sivapalasingam Sumathi, McClelland R. Scott, Ravel Jacques, Ahmed Aabid, Cleland Charles M., Gajer Pawel, Mwamzaka Musa, Marshed Fatma, Shafi Juma, Masese Linnet, Fajans Mark, Anderson Molly E., Jaoko Walter, and Kurth Ann E.. AIDS Research and Human Retroviruses. November 2014, 30(11): 1046-1057. doi:10.1089/aid.2013.0251.Publisher
University of Nairobi
Collections
- Faculty of Health Sciences (FHS) [10385]