IN-VIVO SEMEN-ASSOCIATED PH NEUTRALIZATION OF CERVICOVAGINAL SECRETIONS

Physiological cervicovaginal acidity can partly inactivate human immun odeficiency virus (HIV), Basic semen components should be able to part ially neutralize in vivo cervicovaginal pH. The goals of the study wer e to evaluate the relationship between cervicovaginal pH and presence of semen components in sexually active African women and to assess whe ther vaginal douching with water pet-formed just after sexual intercou rse could significantly reduce semen components and restore physiologi cal cervicovaginal pH, Cervicovaginal secretion (CVS) from 56 heterose xual African women (19 to 45 years old), living in Bangui, Central Afr ican Republic, were evaluated for pH, semen components (prostatic acid phosphatase [PAP] and prostatic specific antigen [PSA]), cellularity, and hemoglobin at inclusion and after vaginal douching with 100 mi of water by using a beck, Before douching, semen components were found i n 46 of 56 CVS (82%), The mean vaginal pH was 5.2 (range, 3.6 to 7.7), and concentrations of both PAP and PSA correlated positively and stro ngly,vith cervicovaginal pH (P < 0.001), After douching, semen compone nts were found in 35 of 56 CVS (62%) (P = 0.03), Cervicovaginal PAP an d PSA levels were significantly decreased (respectively, P < 0.0001 an d P < 0.01; PAP, -72%; PSA, -87%), as was the total cell count (-60%; P < 0.0001), Furthermore, in CVS previously positive for both PAP and PSA, the mean vaginal pH was significantly decreased (6.5 versus 5.3, P < 0.01); no genital bleeding was observed, Frequent persistence of s emen in CVS from heterosexually active African women leads to a shift from acidity to neutrality that could favor male to female HIV transmi ssion, Vaginal douching provides significant elimination of semen afte r sexual intercourse; it should be considered for study as a supplemen tary means for the prevention of heterosexual HIV transmission.