Recovery of Vaginal Flora after Douching Cessation

停止冲洗后阴道菌群的恢复

• 批准号: 6919647
• 负责人: Jonathan M Zenilman
• 金额: $ 6.3万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-03-15 至 2007-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6919647
• 关键词: behavioral /social science research tag; cervical /vaginal smear; clinical research; disease /disorder proneness /risk; female; health behavior; human subject; interview; patient oriented research; vagina; vaginitis; women' s health

DESCRIPTION (provided by applicant): Vaginal douching is a commonly practiced behavior and previous work in Baltimore found that 70 percent of women in the Baltimore STD clinics report current douching. Douching is associated with a number of adverse outcomes, including bacterial vaginosis (BV), cervical infection, pelvic inflammatory disease (PID), and increased risk for ectopic pregnancy. BV, in particular, is associated with an increased risk of pre-term delivery, low birth weight and HIV. Most studies evaluating the effect of douching on risk for BV have been limited in their evaluation of feminine hygiene behavior and have been largely cross-sectional, limiting direct causal inference. Little data are available on how douching affects the vaginal flora on either a short or long-term basis or why women douche. No studies to date have evaluated vaginal flora after discontinuation of douching. We propose a cross-over intervention trial of vaginal douching to evaluate the change in vaginal flora after cessation of douching. We will recruit 150 women who currently douche from posted flyers, the Bayview Medical Center Gynecology clinic and Baltimore City Health Department STD clinics. We will measure the vaginal flora from self-collected samples (with Nugent's criteria) twice per week during a one month douching period. Subjects will then be asked to stop douching, and we will measure vaginal flora twice weekly for two months. Women who return to their normal douching patterns at the conclusion of the study will also be evaluated for a second cross-over exposure sample. Participants will maintain daily sexual and hygiene diaries throughout the study. Generalized estimating equations will be used to assess the following: 1) the effect of vaginal douching cessation on the risk of BV; 2) the risk for BV among women who abstain from douching but then revert to their previous douching habits. Common vaginal douching practices, motivations and techniques will also be evaluated. Data from this research will begin to describe the natural history of BV and aid in the design of behavioral interventions for vaginal douching.

描述（由申请人提供）：阴道冲洗是一种常见的行为，以前在巴尔的摩的工作发现，在巴尔的摩性病诊所70%的妇女报告目前冲洗。冲洗与许多不良后果有关，包括细菌性阴道病（BV）、宫颈感染、盆腔炎（PID）和异位妊娠风险增加。特别是BV与早产、低出生体重和艾滋病毒的风险增加有关。大多数评价冲洗对BV风险影响的研究局限于对女性卫生行为的评价，并且大部分是横断面的，限制了直接的因果推断。关于冲洗如何短期或长期影响阴道植物群或为什么妇女冲洗的数据很少。迄今为止，尚无研究评价停止冲洗后的阴道植物群。我们建议进行一项阴道冲洗的交叉干预试验，以评估停止冲洗后阴道植物群的变化。我们将招募150名妇女谁目前从张贴传单，湾景医疗中心妇科诊所和巴尔的摩市卫生局性病诊所冲洗。我们将在一个月的冲洗期内每周两次测量自收集样本的阴道植物群（采用Nugent标准）。然后要求受试者停止冲洗，我们将每周两次测量阴道植物群，持续两个月。研究结束时恢复正常冲洗模式的女性也将接受第二次交叉暴露样本评价。参与者将在整个研究期间保持每日性和卫生日记。将使用广义估计方程评估以下内容：1）阴道冲洗停止对BV风险的影响; 2）放弃冲洗但随后恢复既往冲洗习惯的女性的BV风险。还将评估常见的阴道冲洗做法、动机和技术。这项研究的数据将开始描述BV的自然史，并有助于设计阴道冲洗的行为干预措施。