Intravaginal practices in a cohort of women at high risk in North-West Tanzania: Baseline associations with HIV Suzanna Francis, Tony Ao, Joseph Chilongani, Bahati Andrew, Deborah Watson-Jones, Saidi Kapiga, Richard Hayes Funded by the UK British Medical Research Council (MRC) and the European and Developing Countries Clinical Trials Partnership (EDCTP)
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Intravaginal practices in a cohort of women at high risk in North-West Tanzania: Baseline associations with HIV Suzanna Francis, Tony Ao, Joseph Chilongani,
3 Observational cohort of women at high risk for HIV in three urban settlements close to mines in North- West Tanzania Objectives: – To describe and quantify reported IVP – To investigate associations between IVP and HIV at the screening visit Background
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Intravaginal practices in a cohort of women at high risk
in North-West Tanzania:
Baseline associations with HIV
Suzanna Francis, Tony Ao, Joseph Chilongani, Bahati Andrew, Deborah Watson-Jones, Saidi Kapiga, Richard
Hayes
Funded by the UK British Medical Research Council (MRC) and the European and Developing Countries Clinical Trials Partnership (EDCTP)
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Intravaginal practices (IVP): cleansing and insertion
IVP are highly prevalent among women in many parts of sub-Saharan Africa
Meta-analysis concluding that some types of IVP are a risk factor for HIV infection
IVP may affect the impact of female controlled HIV prevention methods, such as vaginal microbicides
Why are we interested in IVP?
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Observational cohort of women at high risk for HIV in three urban settlements close to mines in North- West Tanzania
Objectives:– To describe and quantify reported IVP– To investigate associations between IVP and HIV at
the screening visit
Background
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Screening visits: Aug 2008 to Aug 2009 Study population: Women at high risk
– Food vendors– Restaurant / grocery workers– Bar, disco, local brew sellers– Guesthouse / hotel workers
N = 1,800 Screening visit had a face to face questionnaire and
HIV testing
Methods
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Overall HIV Prevalence 21%
HIV Prevalence by occupation– Food vendors 11%
– Restaurant / grocery workers 17%– Bar, disco, local brew sellers 33%– Guesthouse / hotel workers 39%
Results
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Percentage of women reporting IVP
0%
20%
40%
60%
80%
100%
Cleansing Insertion
Description of reported IVP in the past 3 months
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Substances used for cleansing
0%
20%
40%
60%
80%
No cleansing Water only Soap or soapywater
Other
Description of reported IVP in the past 3 months
8
Application methods used for cleansing
0%
20%
40%
60%
80%
No cleansing Fingers only Cloth Cotton, paper,other
Description of reported IVP in the past 3 months
9
Frequency of cleansing
0%
10%
20%
30%
40%
Nocleansing
< daily x1/ day x2/ day x3/ day ≥4/ day
Description of reported IVP in the past 3 months
10
Type of substance inserted
0%
5%
10%
15%
20%
Anyinsertion
Herbs ortraditionalmedicine
Detergent Lemon Gels Other
Description of reported IVP in the past 3 months
11
Unadjusted associations between IVP and HIV
IVP Type HIV+/Total(%) OR (95% CI)Cleansing 353/1,579 (22%) 1.8 (1.2–2.7)
- water only with fingers 57/264 (22%) 1.7(1.0-2.8)
- water & soap with fingers 252/1,107 (23%) 1.8 (1.2-2.8)