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Causation
Vaginal douching increased risk of sexually transmitted infections in high-risk adolescents

http://dx.doi.org/10.1136/ebn.12.3.88

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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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    Footnotes

    • Source of funding: National Institute of Child Health and Human Development; National Institute of Drug Abuse; National Institute of Allergy and Infection Diseases; and National Institute of Mental Health.