Effect of intravaginal practices on the vaginal and cervical mucosa of Zimbabwean women

Objectives: Lesions on the vaginal and cervical mucosa may facilitate trans mission of HIV and other sexually transmitted diseases (STDs). We evaluated the relationship between intravaginal practices and the presence of colpos copic lesions in Zimbabwean women. Methods: Users and nonusers of intravaginal practices were seen at enrollme nt, and at 1 and 6 months. Interviewing, counseling, and pelvic and colposc opic examinations were performed at each study visit. Specimens were collec ted at enrollment and 6 months. Results: Colposcopic lesions were found at least once in 83% of the partici pants (n = 162), and in 66% of all exams (n = 430). Most lesions were class ified as related to infection with human Papillomavirus (HPV) (58%) or anot her pathogen (20%), but 11% of lesions could have been caused by intravagin al practices (signal lesions). Intravaginal practices were not associated w ith an increased incidence in signal lesions (95 and 124 lesions per 100 pe rson-years of follow-up for users and nonusers respectively; p = .290), nor with the presence of signal lesions in multivariate baseline (odds ratio [ OR], 1.32; 95% confidence interval [CI], 037-4.72; p = .666) and six month transition models (OR, 1.67; 95% CT, 0.59-4.70; p = .333). Conclusions: No associations between intravaginal practices and colposcopic lesions were found in this study. However, the potential effect of intrava ginal practices on the cervical and vaginal mucosa, and on subsequent HIV a nd STD transmission, warrants further study, The usefulness of colposcopy a s a research tool in areas with high prevalences of HIV and HPV is question ed.