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Abigail Norris Turner - One of the best experts on this subject based on the ideXlab platform.
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Cessation of Intravaginal practices to prevent bacterial vaginosis: a pilot intervention in Zimbabwean women.
Sexually transmitted infections, 2014Co-Authors: Allahna Esber, Janneke Van De Wijgert, Precious Moyo, Marshall Munjoma, Shelley Francis, Tsungai Chipato, Abigail Norris TurnerAbstract:Objectives Intravaginal practices—including behaviours such as washing with soap or other materials, using fingers or cloth, or insertion of herbs, powders or other products to dry, cleanse or ‘tighten’ the vagina—may increase women9s risk of bacterial vaginosis by disrupting the vaginal microbiota. In Zimbabwe, Intravaginal practices are common. The objective of this study was to assess the feasibility of an intervention based on the transtheoretical model of behaviour change (also called the ‘stages of change’ model) to encourage cessation of vaginal practices among a sample of Zimbabwean women. Methods We conducted a 12-week behaviour change intervention to encourage cessation of Intravaginal practices (other than cleansing with water) among 85 Zimbabwean women who reported these practices. Results Self-reported Intravaginal practices declined significantly over follow-up, with 100% of women reporting at least one Intravaginal practice at enrolment compared with 8% at the final visit. However, we found no significant effect of this reduction on bacterial vaginosis prevalence in unadjusted or adjusted multivariable models (adjusted prevalence ratio for any practice vs none: 0.94, 95% CI 0.61 to 1.43). Conclusions While the intervention was successful in reducing women9s self-reported engagement in Intravaginal practices, we observed no corresponding benefit to vaginal health.
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Effect of treatment assignment on Intravaginal cleansing in a randomized study of the diaphragm with candidate microbicide.
Journal of women's health (2002), 2011Co-Authors: Ana Penman-aguilar, Jennifer Legardy-williams, Abigail Norris Turner, Tiana O.o. Rabozakandriana, D’nyce L. Williams, Sandra Razafindravoavy, Frieda Behets, Kathleen Van Damme, Denise J. JamiesonAbstract:Abstract Background: Intravaginal cleansing may predispose women to adverse health outcomes and may interfere with the effectiveness and safety of female-initiated methods for preventing sexually transmitted infections (STIs). In a 4-week randomized study of 192 Malagasy sex workers, we evaluated associations between self-reported Intravaginal cleansing and randomization assignment: diaphragm with viscous candidate microbicide gel (Acidform™, TOPCAD, Chicago, IL, licensed to Instead, Coppell, TX), diaphragm with placebo hydroxyethylcellulose gel (HEC, ReProtect LLC, Baltimore, MD), Acidform alone, or HEC alone. Methods: Women were counseled to avoid Intravaginal cleansing and were blinded to gel assignment. We evaluated changes in self-reported Intravaginal cleansing across the study and assessed the effects of treatment assignment and covariates on frequent (more than once daily) Intravaginal cleansing. Significant predictors in domain-specific models were evaluated in an all-domain multiple regression m...
Joelle Brown - One of the best experts on this subject based on the ideXlab platform.
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Motivations for Intravaginal Product Use among a Cohort of Women in Los Angeles.
PloS one, 2016Co-Authors: Joelle Brown, Eugenie Poirot, Kristen L Hess, Stephen J Brown, Michele Vertucci, Marjan HezarehAbstract:Objective Intravaginal practices—including behaviors such as Intravaginal cleansing and insertion of products—have been linked to a number of adverse reproductive health outcomes, including increased risk for bacterial vaginosis, sexually transmitted infections, and HIV. Currently, little is known about the motivations for Intravaginal practices among women in the United States. The objective of this study was to identify and describe motivations for Intravaginal washing and Intravaginal insertion of products among women of differing ages and racial/ethnic groups. Methods Between 2008 and 2010, we enrolled a convenience sample of sexually active women aged 18–65 years living in Los Angeles recruited through community education and outreach activities in HIV/AIDS service organizations, women’s health clinics, community-based organizations, and HIV testing sites. At the enrollment visit, women completed a self-administered, computer-assisted questionnaire covering demographics, sexual behaviors, Intravaginal practices, and motivations for Intravaginal practices over the past month and past year. Results We enrolled 141 women; 34% of participants were Caucasian, 40% African American, and 26% Latina. Peri-sexual Intravaginal washing was common in all groups, whether to clean up after sex (70%) or to prepare for sex (54%). African American women were more likely to report learning to wash Intravaginally from their mothers compared to Latina or Caucasian women (70% vs. 49%, P = 0.04). Sixty-one percent of African American women reported using a douching device over the past year compared to 41% of Latina and 40% of Caucasian women (p = 0.02). Younger women were more likely to report that their male partners wanted them to wash Intravaginally than older women (77% vs. 24%, P
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motivations for Intravaginal product use among a cohort of women in los angeles
PLOS ONE, 2016Co-Authors: Joelle Brown, Eugenie Poirot, Kristen L Hess, Stephen J Brown, Michele Vertucci, Marjan HezarehAbstract:Objective Intravaginal practices—including behaviors such as Intravaginal cleansing and insertion of products—have been linked to a number of adverse reproductive health outcomes, including increased risk for bacterial vaginosis, sexually transmitted infections, and HIV. Currently, little is known about the motivations for Intravaginal practices among women in the United States. The objective of this study was to identify and describe motivations for Intravaginal washing and Intravaginal insertion of products among women of differing ages and racial/ethnic groups. Methods Between 2008 and 2010, we enrolled a convenience sample of sexually active women aged 18–65 years living in Los Angeles recruited through community education and outreach activities in HIV/AIDS service organizations, women’s health clinics, community-based organizations, and HIV testing sites. At the enrollment visit, women completed a self-administered, computer-assisted questionnaire covering demographics, sexual behaviors, Intravaginal practices, and motivations for Intravaginal practices over the past month and past year. Results We enrolled 141 women; 34% of participants were Caucasian, 40% African American, and 26% Latina. Peri-sexual Intravaginal washing was common in all groups, whether to clean up after sex (70%) or to prepare for sex (54%). African American women were more likely to report learning to wash Intravaginally from their mothers compared to Latina or Caucasian women (70% vs. 49%, P = 0.04). Sixty-one percent of African American women reported using a douching device over the past year compared to 41% of Latina and 40% of Caucasian women (p = 0.02). Younger women were more likely to report that their male partners wanted them to wash Intravaginally than older women (77% vs. 24%, P<0.01), and more likely to report the removal of odors as a motive than older women (65% vs. 40%, P = 0.04). The most commonly used Intravaginal products included sexual lubricants, petroleum jelly, body lotions, oils, and wet wipes. Use of these products varied by race, and motives given included increasing lubrication, preparing for sex, smelling good, and preventing sexually transmitted infections. Conclusion Women’s Intravaginal practices and motivations for these practices differ across race and age. Motivations for use also vary by type of Intravaginal product used. Given that some Intravaginal practices have been shown to be harmful, interventions, programs and counseling messages to encourage less harmful practices are needed, and should consider underlying motivations that influence women’s vaginal practices. Practitioners may use these results to better support women in achieving vaginal health.
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Intravaginal practices and risk of bacterial vaginosis and candidiasis infection among a cohort of women in the united states
Obstetrics & Gynecology, 2013Co-Authors: Joelle Brown, Kristen L Hess, Stephen J Brown, Colleen Murphy, Ava Lena Waldman, Marjan HezarehAbstract:OBJECTIVE:To measure Intravaginal practices among women of differing ages, ethnicities, and human immunodeficiency virus status and the association between Intravaginal practices and bacterial vaginosis and candidiasis infection.METHODS:Between 2008 and 2010, we recruited and followed sexually activ
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Intravaginal practices bacterial vaginosis and hiv infection in women individual participant data meta analysis
PLOS Medicine, 2011Co-Authors: Nicola Low, Matthew Chersich, Kurt Schmidlin, Matthias Egger, Suzanna C Francis, Janneke Van De Wijgert, Richard J Hayes, Jared M Baeten, Joelle BrownAbstract:Background: Identifying modifiable factors that increase women’s vulnerability to HIV is a critical step in developing effective female-initiated prevention interventions. The primary objective of this study was to pool individual participant data from prospective longitudinal studies to investigate the association between Intravaginal practices and acquisition of HIV infection among women in sub-Saharan Africa. Secondary objectives were to investigate associations between Intravaginal practices and disrupted vaginal flora; and between disrupted vaginal flora and HIV acquisition. Methods and Findings: We conducted a meta-analysis of individual participant data from 13 prospective cohort studies involving 14,874 women, of whom 791 acquired HIV infection during 21,218 woman years of follow-up. Data were pooled using random-effects meta-analysis. The level of between-study heterogeneity was low in all analyses (I 2 values 0.0%– 16.1%). Intravaginal use of cloth or paper (pooled adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.18–1.83), insertion of products to dry or tighten the vagina (aHR 1.31, 95% CI 1.00–1.71), and Intravaginal cleaning with soap (aHR 1.24, 95% CI 1.01–1.53) remained associated with HIV acquisition after controlling for age, marital status, and number of sex partners in the past 3 months. Intravaginal cleaning with soap was also associated with the development of intermediate vaginal flora and bacterial vaginosis in women with normal vaginal flora at baseline (pooled adjusted odds ratio [OR] 1.24, 95% CI 1.04–1.47). Use of cloth or paper was not associated with the development of disrupted vaginal flora. Intermediate vaginal flora and bacterial vaginosis were each associated with HIV acquisition in multivariable models when measured at baseline (aHR 1.54 and 1.69, p,0.001) or at the visit before the estimated date of HIV infection (aHR 1.41 and 1.53, p,0.001), respectively. Conclusions: This study provides evidence to suggest that some Intravaginal practices increase the risk of HIV acquisition but a direct causal pathway linking Intravaginal cleaning with soap, disruption of vaginal flora, and HIV acquisition has not yet been demonstrated. More consistency in the definition and measurement of specific Intravaginal practices is warranted so that the effects of specific Intravaginal practices and products can be further elucidated. Please see later in the article for the Editors’ Summary. Citation: Low N, Chersich MF, Schmidlin K, Egger M, Francis SC, et al. (2011) Intravaginal Practices, Bacterial Vaginosis, and HIV Infection in Women: Individual
Nancys Padian - One of the best experts on this subject based on the ideXlab platform.
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effect of Intravaginal practices on the vaginal and cervical mucosa of zimbabwean women
Journal of Acquired Immune Deficiency Syndromes, 2000Co-Authors: J H H M Van De Wijgert, Z M Chirenje, V Iliff, Michael T Mbizvo, Peter R Mason, Lovemore Gwanzura, Stephen Shiboski, Nancys PadianAbstract:Objectives: Lesions on the vaginal and cervical mucosa may facilitate transmission of HIV and other sexually transmitted diseases (STDs). We evaluated the relationship between Intravaginal practices and the presence of colposcopic lesions in Zimbabwean women. Objectives: Methods: Users and nonusers of Intravaginal practices were seen at enrollment, and at 1 and 6 months. Interviewing, counseling, and pelvic and colposcopic examinations were performed at each study visit. Specimens were collected at enrollment and 6 months. Objectives: Results: Colposcopic lesions were found at least once in 83% of the participants (n = 162), and in 66% of all exams (n = 430). Most lesions were classified as related to infection with human Papillomavirus (HPV) (58%) or another pathogen (20%), but 11% of lesions could have been caused by Intravaginal practices (signal lesions). Intravaginal practices were not associated with an increased incidence in signal lesions (95 and 124 lesions per 100 person-years of follow-up for users and nonusers respectively; p = .290), nor with the presence of signal lesions in multivariate baseline (odds ratio [OR], 1.32; 95% confidence interval [CI], 0.37-4.72; p = .666) and six month transition models (OR, 1.67; 95% CI, 0.59-4.70; p = .333). Objectives: Conclusions: No associations between Intravaginal practices and colposcopic lesions were found in this study. However, the potential effect of Intravaginal practices on the cervical and vaginal mucosa, and on subsequent HIV and STD transmission, warrants further study. The usefulness of colposcopy as a research tool in areas with high prevalences of HIV and HPV is questioned.
Jill Diesel - One of the best experts on this subject based on the ideXlab platform.
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Intravaginal Practices Among Women Attending a Sexually Transmitted Disease Clinic - Philadelphia, 2017.
Sexually transmitted diseases, 2020Co-Authors: Felicia M. T. Lewis, Jill DieselAbstract:We conducted a survey among women attending an urban public sexually transmitted disease clinic to determine type and frequency of Intravaginal cleansing practices. Both Intravaginal washing and douching were frequent, performed mostly for routine hygiene, and associated with self-report of STI and bacterial vaginosis (douching) and bacterial vaginosis (Intravaginal washing).
Annick Larochelle - One of the best experts on this subject based on the ideXlab platform.
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No. 358-Intravaginal Laser for Genitourinary Syndrome of Menopause and Stress Urinary Incontinence
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 2018Co-Authors: Jens-erik Walter, Annick LarochelleAbstract:Abstract Objective This technical bulletin reviews the evidence relating to risks and benefits of using Intravaginal laser technology in the management of genitourinary syndrome of menopause and stress urinary incontinence. Intended Users Gynaecologists, urogynaecologists, urologists, and other health care professionals who assess, counsel, and provide care for women with genitourinary syndrome of menopause and stress urinary incontinence. Target Population Adult women with genitourinary syndrome of menopause and stress urinary incontinence seeking complementary or alternative treatment options to topical estrogen, non-hormonal vaginal moisturizers, physiotherapy, Intravaginal devices, and surgery. Options The discussion relates to Intravaginal laser treatments for genitourinary syndrome of menopause compared with topical estrogen and that for stress urinary incontinence. Outcomes The outcomes of interest are objective and subjective rates of response to treatment, histologic outcomes, and procedural complications. Evidence PubMed, Medline, the Cochrane Database, and EMBASE were searched using the key words "genitourinary syndrome of menopause," "vaginal laser," "topical estrogen," and "urogenital atrophy." Results were restricted to English and human research. Articles were included until the end of September 2016. Clinical practice guidelines and guidelines of specialty societies were reviewed. Included studies were observational or prospective cohort when available. Only publications with study groups larger than or equal to 20 individuals were included, and non–peer-reviewed papers were excluded. Validation Methods The content and recommendations were drafted and agreed upon by the principal authors. The Board of the SOGC approved the final draft for publication. The quality of evidence was rated using the criteria described in the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology framework. Benefits, Harms, and/or Costs It is expected that this technical bulletin will benefit patients with genitourinary syndrome of menopause by ensuring treating physicians are aware of all treatment options including the potential benefit and associated risk with Intravaginal laser therapy. This should guide patient informed consent before such procedures are undertaken. There are no direct harms or costs identified with the implementation of this guideline. Sponsors The SOGC. Summary Statements 1.Histologic evaluation has shown a similar short-term improvement in vaginal epithelial maturation in post-procedural vaginal wall biopsies with the use of Intravaginal laser as that seen with local estrogen (Moderate). 2.Short-term observational studies of small patient number with the use of Intravaginal laser have demonstrated reductions in symptoms (including dryness, burning, itching, dysuria, and dyspareunia) and improvements in sexual satisfaction indices (Low). 3.Short-term observational studies of small patient number with the use of Intravaginal laser have demonstrated improvements in symptoms of stress urinary incontinence (Low). Recommendations 1.In patients declining or with apparent contraindication to local estrogen, Intravaginal laser therapy may be considered for short-term relief of symptoms associated with genitourinary syndrome of menopause (Conditional, Low). 2.There is insufficient evidence to offer Intravaginal laser therapy as an equivalent modality to local estrogen for the treatment of genitourinary syndrome of menopause (including vulvovaginal atrophy, lower urinary tract symptoms, and sexual dysfunction) (Strong, Very Low). 3.There is insufficient evidence to offer Intravaginal laser therapy as an effective modality for the treatment of stress urinary incontinence over alternate managements such as pelvic floor physiotherapy, incontinence pessaries, or surgery (strong, very low). 4.Long-term use of Intravaginal laser therapy for the management of genitourinary syndrome of menopause or stress urinary incontinence remains experimental and should remain within the protocols of well-executed clinical trials in attempts to establish its safety and efficacy (Strong, Very Low). 5.Intravaginal laser therapy should not be offered to patients to prevent recurrent urinary tract infections as no literature exists to support such use (Strong, Very Low).