Re: distinguishing the temporal association between women's intravaginal practices and risk of human immunodeficiency virus infection: a prospective study of South African women

Abstract

In their study of South African women's intravaginal practices and risk of human immunodeficiency virus (HIV) infection, Myer et al. (1) found a significant association between intravaginal practices and HIV serostatus at baseline but not during follow-up. Their results contrast with those from our prospective study of the effect of vaginal washing on HIV acquisition among women in Mombasa, Kenya (2). Compared with women who did not perform vaginal washing, we found an increased risk of HIV acquisition among women who used water (adjusted hazard ratio (HR) = 2.64, 95 percent confidence interval (CI): 1.00, 6.79) or soap (adjusted HR = 3.84, 95 percent CI: 1.51, 9.77) to clean inside the vagina (2). These findings were significant after adjustment for multiple potentially confounding factors