Intravaginal practices and genital human papillomavirus infection among female sex workers in Cambodia

• Published in: Journal of medical virology Vol. 90; no. 11; pp. 1765 - 1774
• Main Authors: Bui, Thanh Cong, Scheurer, Michael E., Pham, Vy Thi‐Tuong, Tran, Ly Thi‐Hai, Hor, Leng Bun, Vidrine, Damon J., Ross, Michael W., Markham, Christine M.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-11-2018
• Subjects: Cambodia; Cleaning; Confidence intervals; douching; female sex workers (FSWs); Genotypes; Health risks; Human papillomavirus; human papillomavirus (HPV); Infections; intravaginal practices (IVPs); Poisson density functions; Prostitution; Regression analysis; Regression models; Risk reduction; Sex; Sex industry; Statistical analysis; Vagina; Virology; Washing; Cambodia; human papillomavirus (HPV); Cambodia; intravaginal practices (IVPs); female sex workers (FSWs); douching
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.25268

Objectives
Intravaginal practices (IVPs) include washing, wiping, or inserting something inside the vagina. This study investigates the associations between IVPs and genital human papillomavirus (HPV) infection.
Methods
We conducted a cross‐sectional study of 200 female sex workers aged 18 to 35 years in Phnom Penh, Cambodia. From August to September 2014. Data on sociodemographic characteristics, IVPs, and other behaviors were collected through face‐to‐face interviews. Self‐collected cervicovaginal specimens were tested for 37 HPV genotypes.
Results
Multivariable Poisson regression models showed that a lower number of infecting HPV genotypes were associated with intravaginal washing in the past 3 months (incident rate ratios [IRR] = 0.65, 95% confidence interval [CI]: 0.46‐0.94) and often performing intravaginal washing shortly after sex (IRR = 0.89, 95% CI: 0.81–0.99). Intravaginal washing before vaginal sex, intravaginal wiping, and intravaginal insertion were not associated with HPV infection.
Conclusion
These findings challenge the existing view that all types of vaginal cleansing are harmful. Specifically, intravaginal washing shortly after sex (mainly with water) may help prevent HPV infection in female sex workers, who have several partners and thus frequently expose to sources of HPV infection with different genotypes.
Highlights
1.Intravaginal practices are very common and complex in Cambodian female sex workers.
2.
HPV infection is prevalent in Cambodian female sex workers.
3.Intravaginal washing after sex might reduce the risk of genital HPV infection.