(P447) Associations between intravaginal and menstrual hygiene practices and Trichomonas vaginalis among women living with HIV in Zambia

Wednesday, July 26, 2023

16:00 – 18:00 CST

Primary Presenter(s)

MM

Misinzo Moono, BA, MSc

Study Coordinator
Centre for Infectious Disease Research in Zambia
Lusaka, Lusaka, Zambia

Co-author(s)

KT

Katayoun Taghavi, FRANZCOG, MMS, MbCHb, PhD

Dr
Institute of Social and Preventive Medicine, University of Bern
Bern, Bern, Switzerland
HK

Herbert Kapesa, BSc

Data Coordinator
Centre for Infectious Disease Research in Zambia
Lusaka, Lusaka, Zambia
AM

Albert Manasyan, MD, MPH

Associate Professor
Division of Neonatology, Department of Pediatrics, School of Medicine, University of Alabama at Birmingham
Birmingham, Alabama, United States

Primary Presenter(s)

Nicola Low, MD (she/her/hers)

Professor of Epidemiology and Public Health
University of Bern
Bern, Bern, Switzerland

Background
Intravaginal practices have been associated with an increased risk of reproductive tract and sexually transmitted infections. Trichomonas vaginalis is not always sexually transmitted and might persist on, and be transmitted from, fomites. Women in Zambia perform a range of vaginal practices to enhance hygiene and sexual experience. Our objective was to examine associations between vaginal and menstrual hygiene practices and T. vaginalis among women living with HIV (WLHIV) in Zambia.

Methods
We enrolled consecutive WLHIV aged 18-65 years into a study of cervical cancer screening strategies at one hospital in Lusaka, Zambia between May 2019 and March 2020. Women who had ever had sex, were not pregnant and provided written consent were eligible. Trained staff took swabs to test for T. vaginalis and human papillomavirus (HPV) (GeneXpert, Cepheid) and asked about socio-economic and clinical characteristics, and about intravaginal and menstrual hygiene practices. We calculated percentages and odds ratios (OR) with 95% confidence intervals (CI).

Results
We enrolled 375 women, of whom 257 (68%) answered questions about menstrual and hygiene practices (Table 1). Median age was 37 years (interquartile range 31–44). The prevalence of T. vaginalis was 19% (95% CI 15-23, 70/375) and of HPV 44% (38-49, 163/375). T. vaginalis was not associated with sexual partner numbers (1+ vs. 0 in last year, OR 1.31, 95% CI 0.55-3.48). T. vaginalis was more common in women who clean inside their vagina than those who did not (OR 1.73 1.01-2.99). Use of cloths for washing was common but T. vaginalis was not associated with ways in which cloths were stored. T. vaginalis was more common among women no longer having periods (OR 2.08, 0.98-4.41). Among women having periods, T. vaginalis was not associated with menstrual hygiene practices.

Conclusion
Among WLHIV, T. vaginalis was not associated with sexual partner numbers, but was associated with intravaginal washing and no longer having periods. We asked about several practices related to the storage of cloths for washing but did not find associations between storage practices that could facilitate fomite transmission. Further investigation of factors associated with non-sexual transmission of T. vaginalis is warranted.