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Prevalence, motivations, and adverse effects of vaginal practices in Africa and Asia : findings from a multicountry household survey

(2011) JOURNAL OF WOMENS HEALTH. 20(7). p.1097-1109
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Abstract
Background: Women worldwide use various vaginal practices to clean or modify their vulva and vagina. Additional population-level information is needed on prevalence and motivations for these practices, characteristics of users, and their adverse effects. Methods: This was a household survey using multistage cluster sampling in Tete, Mozambique; KwaZulu-Natal, South Africa; Yogyakarta, Indonesia; and Chonburi, Thailand. In 2006-2007, vaginal practices and their motivations were examined using structured interviews with women 18-60 years of age (n = 3610). Results: Prevalence, frequency, and motivations varied markedly. Two thirds of women in Yogyakarta and Chonburi reported one or more practices. In Yogyakarta, nearly half ingest substances with vaginal effects, and in Chonburi, external washing and application predominate. In Tete, half reported three or four current practices, and a quarter reported five or more practices. Labial elongation was near universal, and 92% of those surveyed cleanse internally. Two third's in KwaZulu-Natal practiced internal cleansing. Insertion of traditional solid products was rare in Chonburi and Yogyakarta, but one tenth of women in KwaZulu-Natal and nearly two thirds of women in Tete do so. Multivariate analysis of the most common practice in each site showed these were more common among less educated women in Africa and young urban women in Asia. Explicit sexual motivations were frequent in KwaZulu-Natal and Tete, intended for pleasure and maintaining partner commitment. Practices in Chonburi and Yogyakarta were largely motivated by femininity and health. Genital irritation was common at African sites. Conclusions: Vaginal practices are not as rare, exotic, or benign as sometimes assumed. Limited evidence of their biomedical consequences remains a concern; further investigation of their safety and sexual health implications is warranted.
Keywords
PREVENTION, RISK, INFECTION, SOUTH-AFRICA, CONTROLLED-TRIAL, WOMENS HEALTH, MICROBICIDE ACCEPTABILITY, HIV ACQUISITION, INTRAVAGINAL PRACTICES, SEXUALLY-TRANSMITTED-DISEASES

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Citation

Please use this url to cite or link to this publication:

Chicago
Hull, Terence, Adriane Martin Hilber, Matthew Chersich, Brigitte Bagnol, Aree Prohmmo, Jennifer A Smit, Ninuk Widyantoro, et al. 2011. “Prevalence, Motivations, and Adverse Effects of Vaginal Practices in Africa and Asia : Findings from a Multicountry Household Survey.” Journal of Womens Health 20 (7): 1097–1109.
APA
Hull, T., Hilber, A. M., Chersich, M., Bagnol, B., Prohmmo, A., Smit, J. A., Widyantoro, N., et al. (2011). Prevalence, motivations, and adverse effects of vaginal practices in Africa and Asia : findings from a multicountry household survey. JOURNAL OF WOMENS HEALTH, 20(7), 1097–1109.
Vancouver
1.
Hull T, Hilber AM, Chersich M, Bagnol B, Prohmmo A, Smit JA, et al. Prevalence, motivations, and adverse effects of vaginal practices in Africa and Asia : findings from a multicountry household survey. JOURNAL OF WOMENS HEALTH. 2011;20(7):1097–109.
MLA
Hull, Terence, Adriane Martin Hilber, Matthew Chersich, et al. “Prevalence, Motivations, and Adverse Effects of Vaginal Practices in Africa and Asia : Findings from a Multicountry Household Survey.” JOURNAL OF WOMENS HEALTH 20.7 (2011): 1097–1109. Print.
@article{1923768,
  abstract     = {Background: Women worldwide use various vaginal practices to clean or modify their vulva and vagina. Additional population-level information is needed on prevalence and motivations for these practices, characteristics of users, and their adverse effects. 
Methods: This was a household survey using multistage cluster sampling in Tete, Mozambique; KwaZulu-Natal, South Africa; Yogyakarta, Indonesia; and Chonburi, Thailand. In 2006-2007, vaginal practices and their motivations were examined using structured interviews with women 18-60 years of age (n = 3610). 
Results: Prevalence, frequency, and motivations varied markedly. Two thirds of women in Yogyakarta and Chonburi reported one or more practices. In Yogyakarta, nearly half ingest substances with vaginal effects, and in Chonburi, external washing and application predominate. In Tete, half reported three or four current practices, and a quarter reported five or more practices. Labial elongation was near universal, and 92\% of those surveyed cleanse internally. Two third's in KwaZulu-Natal practiced internal cleansing. Insertion of traditional solid products was rare in Chonburi and Yogyakarta, but one tenth of women in KwaZulu-Natal and nearly two thirds of women in Tete do so. Multivariate analysis of the most common practice in each site showed these were more common among less educated women in Africa and young urban women in Asia. Explicit sexual motivations were frequent in KwaZulu-Natal and Tete, intended for pleasure and maintaining partner commitment. Practices in Chonburi and Yogyakarta were largely motivated by femininity and health. Genital irritation was common at African sites. 
Conclusions: Vaginal practices are not as rare, exotic, or benign as sometimes assumed. Limited evidence of their biomedical consequences remains a concern; further investigation of their safety and sexual health implications is warranted.},
  author       = {Hull, Terence and Hilber, Adriane Martin and Chersich, Matthew and Bagnol, Brigitte and Prohmmo, Aree and Smit, Jennifer A and Widyantoro, Ninuk and Utomo, Iwu Diswetyani and Francois, Isabelle and Tumwesigye, Nazarius Mbona and Temmerman, Marleen},
  issn         = {1540-9996},
  journal      = {JOURNAL OF WOMENS HEALTH},
  keyword      = {PREVENTION,RISK,INFECTION,SOUTH-AFRICA,CONTROLLED-TRIAL,WOMENS HEALTH,MICROBICIDE ACCEPTABILITY,HIV ACQUISITION,INTRAVAGINAL PRACTICES,SEXUALLY-TRANSMITTED-DISEASES},
  language     = {eng},
  number       = {7},
  pages        = {1097--1109},
  title        = {Prevalence, motivations, and adverse effects of vaginal practices in Africa and Asia : findings from a multicountry household survey},
  url          = {http://dx.doi.org/10.1089/jwh.2010.2281},
  volume       = {20},
  year         = {2011},
}

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