Does douching increase risk for sexually transmitted infections? A prospective study in high-risk adolescents

Received 17 January 2008; received in revised form 30 March 2008; accepted 5 June 2008. published online 31 July 2008.

Refers to article:

Douching and the risk for sexually transmitted disease: Tsai et al
Jenifer E. Allsworth, Katherine J. Hladky, Taylor Hotchkiss, Colleen McNicholas, Amanda Rohn
American Journal of Obstetrics & Gynecology
January 2009 (Vol. 200, Issue 1, Pages 112-113)
Abstract | Full Text | Full-Text PDF (119 KB)

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

a Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN

b Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN

c Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN

d Division of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT

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

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