Intravaginal practices and genital human papillomavirus infection among female sex workers in Cambodia

Thanh Cong Bui, Michael E. Scheurer, Vy Thi Tuong Pham, Ly Thi Hai Tran, Leng Bun Hor, Damon J. Vidrine, Michael W. Ross, Christine M. Markham

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objectives: Intravaginal practices (IVPs) include washing, wiping, or inserting something inside the vagina. This study investigates the associations between IVPs and genital human papillomavirus (HPV) infection. Methods: We conducted a cross-sectional study of 200 female sex workers aged 18 to 35 years in Phnom Penh, Cambodia. From August to September 2014. Data on sociodemographic characteristics, IVPs, and other behaviors were collected through face-to-face interviews. Self-collected cervicovaginal specimens were tested for 37 HPV genotypes. Results: Multivariable Poisson regression models showed that a lower number of infecting HPV genotypes were associated with intravaginal washing in the past 3 months (incident rate ratios [IRR] = 0.65, 95% confidence interval [CI]: 0.46-0.94) and often performing intravaginal washing shortly after sex (IRR = 0.89, 95% CI: 0.81–0.99). Intravaginal washing before vaginal sex, intravaginal wiping, and intravaginal insertion were not associated with HPV infection. Conclusion: These findings challenge the existing view that all types of vaginal cleansing are harmful. Specifically, intravaginal washing shortly after sex (mainly with water) may help prevent HPV infection in female sex workers, who have several partners and thus frequently expose to sources of HPV infection with different genotypes.

Original languageEnglish (US)
Pages (from-to)1765-1774
Number of pages10
JournalJournal of Medical Virology
Issue number11
StatePublished - Nov 2018

Bibliographical note

Publisher Copyright:
© 2018 Wiley Periodicals, Inc.


  • Cambodia
  • douching
  • female sex workers (FSWs)
  • human papillomavirus (HPV)
  • intravaginal practices (IVPs)


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