TY - JOUR
T1 - Understanding Women’s Vaginal Douching Behaviors and Practices for Consideration in the Development of a Potential Future Vaginal Microbicide Douche for HIV Prevention
T2 - A Systematic Review of the Literature
AU - Rael, Christine Tagliaferri
AU - Das, Doyel
AU - Bauermeister, Jose
AU - Lentz, Cody
AU - Carballo-Diéguez, Alex
AU - Giguere, Rebecca
AU - Scott, Rachel K.
AU - Hendrix, Craig W.
N1 - Funding Information:
The first author is supported by a K01 Award (K01 MH115785; Principle Investigator: Christine Rael, Ph.D.) from the National Institute of Mental Health at the HIV Center for Clinical and Behavioral Studies at the NY State Psychiatric Institute and Columbia University (P30 MH43520; Center Principle Investigator: Robert Remien, Ph.D.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2021/9
Y1 - 2021/9
N2 - Despite clinicians consistently advising against vaginal douching, 29–92% of women worldwide report douching. This review documents women’s douching practices, motivations for douching, and specific associations (or absence of associations) between vaginal douche use and vaginal outcomes thought to be associated with douching. Understanding women’s existing douching behaviors and vaginal health outcomes is critical for developing a safe vaginal microbicide douche that can be used as HIV pre-exposure prophylaxis (PrEP). A vaginal douche as PrEP could help prevent new HIV infections, since emerging evidence shows some women discontinue oral PrEP. We performed a systematic review of the literature using the guidelines for Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). Articles included in the analysis (N = 48) were published 2009–2019 in English and focused on women’s experiences with douching. Two trained independent reviewers assessed these articles for content on vaginal douching, including racial/ethnic focus of studies, study design, sampling, women’s reasons for douching, contents of douche solutions, and associations between vaginal douching and vaginal health outcomes. Several studies focused on Black women (N = 12 studies) or had no racial/ethnic focus (N = 12). Just over half of all studies (N = 24) were cross-sectional and involved a self-reported questionnaire and lab samples. Studies sampled women from health clinics where they were (N = 13) or were not (N = 14) presenting for vaginal health complaints. Women’s primary motivation for douching was for “general cleanliness” (N = 13), and most douche solutions contained water (N = 12). There was little empirical agreement between vaginal douche use and most vaginal health outcomes. Future studies of PrEP vaginal douches should be well controlled and prioritize safety to ensure positive vaginal health outcomes.
AB - Despite clinicians consistently advising against vaginal douching, 29–92% of women worldwide report douching. This review documents women’s douching practices, motivations for douching, and specific associations (or absence of associations) between vaginal douche use and vaginal outcomes thought to be associated with douching. Understanding women’s existing douching behaviors and vaginal health outcomes is critical for developing a safe vaginal microbicide douche that can be used as HIV pre-exposure prophylaxis (PrEP). A vaginal douche as PrEP could help prevent new HIV infections, since emerging evidence shows some women discontinue oral PrEP. We performed a systematic review of the literature using the guidelines for Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). Articles included in the analysis (N = 48) were published 2009–2019 in English and focused on women’s experiences with douching. Two trained independent reviewers assessed these articles for content on vaginal douching, including racial/ethnic focus of studies, study design, sampling, women’s reasons for douching, contents of douche solutions, and associations between vaginal douching and vaginal health outcomes. Several studies focused on Black women (N = 12 studies) or had no racial/ethnic focus (N = 12). Just over half of all studies (N = 24) were cross-sectional and involved a self-reported questionnaire and lab samples. Studies sampled women from health clinics where they were (N = 13) or were not (N = 14) presenting for vaginal health complaints. Women’s primary motivation for douching was for “general cleanliness” (N = 13), and most douche solutions contained water (N = 12). There was little empirical agreement between vaginal douche use and most vaginal health outcomes. Future studies of PrEP vaginal douches should be well controlled and prioritize safety to ensure positive vaginal health outcomes.
KW - Behaviorally congruent
KW - Microbicides
KW - Topical HIV prevention
KW - Topical PrEP
KW - Vaginal microbicide douche
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U2 - 10.1007/s10461-021-03290-0
DO - 10.1007/s10461-021-03290-0
M3 - Article
C2 - 33977356
AN - SCOPUS:85105863626
SN - 1090-7165
VL - 25
SP - 2992
EP - 3010
JO - AIDS and behavior
JF - AIDS and behavior
IS - 9
ER -