TRADITIONAL VAGINAL AGENTS - USE AND ASSOCIATION WITH HIV-INFECTION IN MALAWIAN WOMEN

Objectives: To assess the prevalence of traditional vaginal agent use in Malawian women and its association with HIV infection. Methods: Con senting, consecutive antenatal women were administered a questionnaire and screened for sexually transmitted diseases (STD) including HIV. R esults: Of the 6603 consenting women, 886 (13%) reported using intrava ginal agents for tightening and 2222 (34%) for self-treatment of vagin al discharge and itching. A higher proportion of HIV-infected than uni nfected women (17% versus 14%) reported use of intravaginal agents for treatment (odds ratio, 1.29; 95% confidence interval, 1.05-1.57),but no difference in HIV status was found when these agents were used for tightening. In multivariate analysis, vaginal agent use for treatment was independently associated with HIV seropositivity. Conclusions: The association of HIV infection with vaginal agents for self-treatment, but not for tightening, suggests that STD may play a role or that vagi nal agents are used differently for the two purposes. In addition to a small increased risk of HIV infection associated with vaginal agent u se, these agents may interfere with condom effectiveness or acceptabil ity of vaginal microbicides.