Vaginal Douching Practices Among Women Presenting to An Urban STD Clinic

Background: Vaginal douching is a common practice in the U.S. despite potential associations with sexually transmitted infections (STIs), bacterial vaginosis (BV) and other adverse health outcomes.

Objectives: To examine douching practices of Black and Latina women presenting to the Miami DOH STD clinic and to examine associations between douching and STIs/BV.

Methods: Data was abstracted from clinical encounter forms, laboratory records, and financial records of female patients seen between December 2008 and February 2009.

Results: Of 204 women (mean age 28), sixty-four (31.4%) were Hispanic and 132 (64.7%) were non-Hispanic (127 black, 5 white). Fifty-nine (28.9%) were born outside the U.S., and most (66.7%) lived on an income less than 10,000 per year. Most (52.0%) had a prior STI, 19.6% had more than 4 pregnancies, and 19.1% reported more than 2 sexual partners in the 2 months prior to the study visit. Only 8.2% reported consistent condom use. Fifty-one women (25%) reported douching in the 30 days prior to the study visit. Overall, there were 30 chlamydia cases (14.7% of sample), 10 gonorrhea cases (4.9%), and 53 cases of BV (26.0%) confirmed by laboratory data. Younger age, non-white race, non-Hispanic ethnicity, and birthplace in the US were significantly associated with gonorrhea and chlamydia in the study sample. Douching in the past 30 days was not associated with gonorrhea and chlamydia (p=.916), but was significantly associated with a laboratory-confirmed diagnosis of BV (p=.004).

Conclusions:  In our sample from an urban STD clinic serving a diverse clientele, douching was common. Douching was associated with BV but not gonorrhea or chlamydia.

Implications for Programs, Policy, and/or Research: Counseling regarding douching cessation should be provided to women of varied ethnic backgrounds due to the adverse health consequences of the practice.