TY - JOUR
T1 - An effective intervention to reduce intravaginal practices among HIV-1 uninfected Kenyan women
AU - Sivapalasingam, Sumathi
AU - McClelland, R. Scott
AU - Ravel, Jacques
AU - Ahmed, Aabid
AU - Cleland, Charles M.
AU - Gajer, Pawel
AU - Mwamzaka, Musa
AU - Marshed, Fatma
AU - Shafi, Juma
AU - Masese, Linnet
AU - Fajans, Mark
AU - Anderson, Molly E.
AU - Jaoko, Walter
AU - Kurth, Ann E.
N1 - Publisher Copyright:
© 2014 Mary Ann Liebert, Inc.
PY - 2014
Y1 - 2014
N2 - 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.
AB - 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.
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U2 - 10.1089/aid.2013.0251
DO - 10.1089/aid.2013.0251
M3 - Article
C2 - 25265254
AN - SCOPUS:84931436629
SN - 0889-2229
VL - 30
SP - 1046
EP - 1054
JO - AIDS Research and Human Retroviruses
JF - AIDS Research and Human Retroviruses
IS - 11
ER -