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QUESTION
Does vaginal douching increase risk of sexually transmitted infections (STIs) in high-risk adolescents?
METHODS
Design:
prospective cohort study (substudy of Reaching for Excellence in Adolescent Care and Health [REACH] Project) with median follow-up of 3 years.
Setting:
16 centres in the USA.
Participants:
368 females 12–19 years of age (mean age 17 y, 65% had HIV infection) who were considered to be at high risk of STIs and were STI-free at baseline or became STI-free after treatment.
Risk factor:
douching status (assessed every 6 mo): never (did not report douching at any visit), intermittent (reported douching at some, but not all, visits), or always (reported douching at all visits).
Outcomes:
incidence of an STI (Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, or herpes …
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