Douching Behaviors Reported by Adolescent and Young Adult Women at High Risk for Sexually Transmitted Infections

Study Objective: To describe frequency of douching and reasons as timing to menses, vaginal symptoms, and coitus and the association of these behaviors to the diagnosis of three sexually acquired infections. Design, Setting, Participants: The study involved 160 females between the ages of 14 and 25 yrs attending a STD clinic and/or community adolescent health clinics. Subjects were eligible to enter the study if they had a positive test(s) for and/or were a contact of chlamydia, gonorrhea, trichomonas, and/or nongonococcal urethritis (NGU). Reevaluation for these infections occurred at the 1-month, 4-month, and 7-month visit with one-dose antibiotic treatment provided for positive tests. Data on douching was collected at the 7-month visit only. Main Outcome Measure: Results of tests for STIʹs using urine-based DNA-amplification techniques for chlamydia and gonorrhea and using self-obtained vaginal swabs for trichomonas culture. Results: Nearly two-thirds (106/160) of the subjects ages 14–25 yrs completing the 7-month visit reported douching, with 67.7% (69/102) reporting douching once a month or more. Douching was more common in older, black participants, using injectable progestins for contraception. Douching was more common in those reporting more recent sexual partners. Douching related to menses was not associated with any of the three infections, while douching related to symptoms and coitus was associated with positive tests for infections. Conclusions: Results suggest that for this subset of teens at high risk for sexually acquired infections, douching is a commonly reported behavior. This study suggests that the linkage of douching and sexually acquired infections is associated with contraceptive choices, self-treatment of vaginal symptoms, and sexual risk behaviors but not menstrual hygiene.