Bacterial vaginosis and intravaginal practices among Peruvian female sex workers

Background

Bacterial vaginosis (BV) is of concern for female sex workers (FSW) because of its association with increased susceptibility for sexually transmitted infections (STI), especially HIV. BV risk factors include new or multiple sex partners, douching, lack of condom use, and limited education. Little is known regarding BV prevalence rates among Latin American FSW and their intravaginal practices that may be associated with BV.

Objective

Develop a profile of intravaginal practices and evaluate the association between BV and ingredients of intravaginal products using Peruvian surveillance study data of FSW.

Methods

Descriptive statistics characterized 184 women with and without BV. Multivariate logistic regression was used to evaluate the association between BV and ingredients adjusted for potential confounding factors (age, education, number of partners, years self-identified as sex worker, condom use, and socio-economic status) and simultaneous use of other ingredients.

Results

Women with BV were predominantly street-based FSW (60.0%) and most had concurrent STI (96.5%). Women without BV were less street-based FSW (42.3%) and 76.9% had concurrent STI. One-hundred-fourteen women reported intravaginal practices and described 10 ingredients ranging from regional herbs to steroids. Mean frequency of practices in previous week was 31, driven primarily by insertion of lubricants. In multivariate logistic regression only the use of antifungal products had a marginally protective effect against BV (OR=0.10, p=0.05).

Conclusion

Further research is needed on multiple intravaginal practices, intravaginal products, motivation for use, and the sources of medication and health care information in the absence of STI clinic visits by FSW in Peru.