Background: Vaginal cleaning practices may have an effect on the normal vaginal flora, making women susceptible to infections such as bacterial vaginosis, pelvic inflammatory disease, HIV and other sexually transmitted infections. Vaginal cleaning practices may also affect the use and effectiveness of vaginal microbicide gels. This study explored women's vaginal cleaning practices in the setting of a microbicide trial in Mazabuka, Zambia. Methods: In-depth interviews were conducted with a random sub-sample of 30 participants four weeks after enrolment. Four focus group discussions (FGDs) with purposely-selected trial participants and 6 FGDs with conveniently selected community members (3 for males and 3 for females) were also conducted. Participants were asked about the vaginal cleaning practices in their community and among participants. All transcripts were analysed thematically. Results: FGDs with community members suggested that vaginal cleaning was common among women. Most women cleaned inside their vagina immediately after sex by wiping with a piece of cloth. The main reason was hygiene. FGDs and IDIs with women participants showed that most of them cleaned inside the vagina using a finger or piece of cloth. The main reason was to remove semen. However, most participants indicated that they cleaned one hour after sex, to adhere to counsellors' advice given at enrolment. On the other hand, a few participants reported that they only cleaned the outer parts of the vagina. The main reason was to let the gel work as advised by the counsellors. CONCLUSIONS: In this community, it is common for women to clean inside their vagina immediately after sex. However, most study participants indicated that they cleaned inside the vagina only one hour after sex, as advised. This suggests that potentially harmful vaginal practices that are common in the community may be open to change through counselling and education. Further research is needed.
Poster from Microbicides 2008, New Delhi, India, 24-27 February 2008.