Volume 200, Issue 1 , Pages 38.e1-38.e8, January 2009
Does douching increase risk for sexually transmitted infections? A prospective study in high-risk adolescents
Objective
The objective of the study was to examine the association between douching and 4 sexually transmitted infections (STIs).
Study Design
We followed up 411 high-risk human immunodeficiency virus-infected and uninfected female adolescents aged 12-19 years over a median 3-year period, both by time from study entry/first STI-free visit until an incident STI for participants who never, intermittently, and always douched and also by reported douching at a given STI-free visit and incidence of STI at the next visit, using adjusted Cox proportional hazards models to calculate hazard ratios (HR).
Results
The time to STI was shorter for adolescents who always (HR, 2.1; 95% confidence interval [CI], 1.2-3.4) and intermittently (HR, 1.5; 95% CI, 1.0-2.2) douched, compared with never-douchers. An adjusted hazard for STI was 1.8 times larger for always-douchers (95% CI, 1.1-3.1) and 1.4 times larger for intermittent douchers (95% CI, 0.9-2.0), compared with never-douchers. When classifying by follow-up after an STI-free visit, always-douchers had a shorter STI-free time than never-douchers (HRadj, 2.1; 95% CI, 1.5-3.1).
Conclusion
Counseling to discourage douching may reduce STI risk in adolescents.
Key words: douching, female adolescents, HIV infection, sexually transmitted infections
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Cite this article as: Tsai CS, Shepherd BE, and Vermund SH. Does douching increase risk for sexually transmitted infections? A prospective study in high-risk adolescents. Am J Obstet Gynecol 2009;200:38.e1-38.e8.
Ms Tsai is now a medical student at Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL.
The REACH study was funded by grant U01-HD32842 from the National Institute of Child Health and Human Development with cofunding from the National Institute on Drug Abuse, the National Institute of Allergy and Infectious Diseases, and the National Institute of Mental Health. Support for the analytic work was received from the Vanderbilt-Meharry Center for AIDS Research through grant P30AI054999 from the National Institute of Allergy and Infectious Diseases.
Reprints not available from the authors.
PII: S0002-9378(08)00636-4
doi:10.1016/j.ajog.2008.06.026
© 2009 Mosby, Inc. All rights reserved.
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Douching and the risk for sexually transmitted disease: Tsai et al
Volume 200, Issue 1 , Pages 38.e1-38.e8, January 2009
