Vaginal Practices among Women at High Risk of HIV Infection in Uganda and Tanzania: Recorded Behaviour from a Daily Pictorial Diary
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Date
2013
Journal Title
Journal ISSN
Volume Title
Publisher
Claire Thorne
Abstract
Background: Intravaginal practices (IVP) are highly prevalent in sub-Saharan African and have been implicated as risk factors
for HIV acquisition. However, types of IVP vary between populations, and detailed information on IVP among women at risk
for HIV in different populations is needed. We investigated IVP among women who practice transactional sex in two
populations: semi-urban, facility workers in Tanzania who engage in opportunistic sex work; and urban, self-identified sex
workers and bar workers in Uganda. The aim of the study was to describe and compare IVP using a daily pictorial diary.
Methodology/Principal Findings: Two hundred women were recruited from a HIV prevention intervention feasibility study
in Kampala, Uganda and in North-West Tanzania. Women were given diaries to record IVP daily for six weeks. Baseline data
showed that Ugandan participants had more lifetime partners and transactional sex than Tanzanian participants. Results
from the diary showed that 96% of Tanzanian participants and 100% of Ugandan participants reported intravaginal
cleansing during the six week study period. The most common types of cleansing were with water only or water and soap.
In both countries, intravaginal insertion (e.g. with herbs) was less common than cleansing, but insertion was practiced by
more participants in Uganda (46%) than in Tanzania (10%). In Uganda, participants also reported more frequent sex, and
more insertion related to sex. In both populations, cleansing was more often reported on days with reported sex and during
menstruation, and in Uganda, when participants experienced vaginal discomfort. Participants were more likely to cleanse
after sex if they reported no condom use. Conclusions: While intravaginal cleansing was commonly practiced in both cohorts, there was higher frequency of cleansing and insertion in Uganda. Differences in IVP were likely to reflect differences in sexual behaviour between populations, and may warrant different approaches to interventions targeting IVP. Vaginal practices among women at high risk in Uganda and Tanzania: recorded behaviour from a daily pictorial diary
Description
Keywords
Vaginal practices, transactional sex, women
Citation
Francis SC, Baisley K, Lees SS, Andrew B, Zalwango F, et al. (2013) Vaginal Practices among Women at High Risk of HIV Infection in Uganda and Tanzania: Recorded Behaviour from a Daily Pictorial Diary. PLoS ONE 8(3): e59085. doi:10.1371/journal.pone.0059085