dc.identifier.citation | Balkus, J. E., Manguro, G., Abdalla, A., Ngacha, C., Shafi, J., Kiarie, J., ... & McClelland, R. S. (2013). P3. 059 Effect of Vaginal Washing on Lactobacillus Colonisation in HIV-Negative Kenyan Women. Sexually Transmitted Infections, 89(Suppl 1), A166-A166. | en_US |
dc.description.abstract | Background Vaginal washing has been associated with an
increased risk of bacterial vaginosis (BV) and a decreased likelihood
of vaginal Lactobacillus colonisation. We sought to determine
whether a lower prevalence of Lactobacillus colonisation in women
reporting vaginal washing was independent of the effect of BV.
Methods We conducted a cross-sectional study of 273 HIV-negative female sex workers
enrolled in an open cohort study in Mombasa, Kenya. Vaginal washing and sexual risk
behaviours were
assessed using structured face-to-face interviews. Lactobacillus species were detected by plating
vaginal swabs on both Rogosa and
Columbia 5% sheep blood agars. We used tetramethylbenzidine agar
subculture to assess H
2O2-production. BV was detected by Gram
stain. Log-binomial regression was used to assess correlates of Lactobacillus colonisation,
including vaginal washing, controlling for BV.
Results Two-hundred eighteen participants (80%) reported vaginal washing in the past week
(median frequency per week = 14;
range 1–35). Lactobacillus species were detected in 50/218 (23%)
participants who reported vaginal washing versus 23/55 (42%) who
did not report this practise. Similarly, H2O2-producing Lactobacillus
species were detected in 13/218 (6%) participants who reported
vaginal washing versus 10/55 (18%) who did not. After controlling
for age, unprotected sex, and BV, vaginal washing was associated
with a lower likelihood of any Lactobacillus (adjusted relative risk
[aRR] = 0.55; 95% confience interval [CI] 0.37–0.81) and H2O2-
producing Lactobacillus (aRR = 0.33; 95% CI 0.15–0.73).
Conclusion Vaginal washing was associated with a lower likelihood of any Lactobacillus and
H2O2-producing Lactobacillus species
detected by culture. The results of our adjusted analysis suggest
that the effect of vaginal washing on lactobacilli is not mediated
entirely through the higher prevalence of BV associated with this
practise. Prospective studies will be important to determine whether
cessation of vaginal washing could improve vaginal health by promoting vaginal colonisation
with Lactobacillus | en_US |