Table 2 infection Factor Intravaginal practices Vaginal cleansing{ Does not cleanse Once daily Twice daily >3 times/day Usual method of cleansing{ Does not cleanse Water only Soap & water Other products Insert substances for wet sex{ No Yes Insert substances for dry sex{ No Yes Any IVP in last 24 h{ No 13–24 h ago 7–12 h ago (6 h ago Menstrual hygiene{ Sanitary pads Cloths/underwear/sponges Cotton wool/toilet paper Last menstrual period{ ,7 days 7–13 days >14 days Biological factors HIV No Yes Trichomonas vaginalis{ No Yes Neisseria gonorrhoeae{ No Yes Chlamydia trachomatis{ No Yes Candidiasis{ No Yes HIV genital shedding1 No Yes HSV-2 genital shedding" No Yes 292/451 (64.7%) 47/74 (63.5%) 174/282 (61.7%) 293/473 (61.9%) 292/451 (64.7%) 86/142 (60.6%) 368/600 (61.3%) 60/87 (69.0%) 722/1158 (62.3%) 84/124 (67.7%) 777/1220 (63.7%) 29/62 (46.8%) 254/413 (61.5%) 149/230 (64.8%) 164/255 (64.3%) 240/385 (62.3%) 135/229 (59.0%) 623/988 (63.1%) 39/51 (76.5%) 216/350 (61.7%) 197/296 (66.6%) 382/612 (62.4%) 483/813 (59.4%) 324/470 (68.9%) 530/889 (59.6%) 274/390 (70.3%) 758/1215 (62.4%) 48/67 (71.6%) 754/1193 (63.2%) 52/89 (58.4%) 718/1145 (62.7%) 87/134 (64.9%) 161/223 (72.2%) 162/246 (65.9%) 513/811 (63.3%) 65/103 (63.1%) p = 0.79; p trend = 0.34 1 0.95 (0.57 to 1.58) 0.88 (0.64 to 1.19) 0.89 (0.68 to 1.16) p = 0.39 1 0.84 (0.57 to 1.23) 0.86 (0.67 to 1.11) 1.21 (0.74 to 1.98) p = 0.23 1 1.27 (0.85 to 1.88) p = 0.008 1 0.50 (0.30 to 0.84) p = 0.81; p trend = 0.81 1 1.15 (0.82 to 1.61) 1.13 (0.82 to 1.56) 1.04 (0.78 to 1.38) p = 0.05 1 1.19 (0.89 to 1.59) 2.26 (1.13 to 4.55) p = 0.38 1 1.23 (0.89 to 1.71) 1.03 (0.79 to 1.35) p,0.001 1 1.52 (1.19 to 1.93) p,0.001 1 1.60 (1.24 to 2.06) p = 0.13 1 1.52 (0.88 to 2.62) p = 0.37 1 0.82 (0.53 to 1.27) p = 0.61 1 1.10 (0.76 to 1.60) p = 0.14 1 0.74 (0.50 to 1.10) p = 0.98 1 0.99 (0.65 to 1.52) p = 0.36; p trend = 0.10 1 0.95 (0.56 to 1.62) 0.78 (0.56 to 1.08) 0.80 (0.60 to 1.07) p = 0.20 1 0.78 (0.52 to 1.18) 0.78 (0.60 to 1.02) 1.11 (0.66 to 1.87) p = 0.99 1 1.00 (0.66 to 1.52) p = 0.004 1 0.45 (0.26 to 0.78) p = 0.89; p trend = 0.99 1 1.05 (0.74 to 1.49) 1.12 (0.80 to 1.57) 0.98 (0.73 to 1.33) p = 0.02 1 1.34 (0.97 to 1.85) 2.53 (1.23 to 5.24) p = 0.40 1 1.23 (0.88 to 1.74) 1.02 (0.77 to 1.36) p = 0.002 1 1.49 (1.16 to 1.92) p = 0.002 1 1.54 (1.17 to 2.01) p = 0.60 1 1.16 (0.65 to 2.07) p = 0.11 1 0.69 (0.44 to 1.08) p = 0.59 1 1.12 (0.75 to 1.65) p = 0.20 1 0.76 (0.50 to 1.15) p = 0.77 1 0.93 (0.60 to 1.46) Association of intravaginal practices (IVP) and biological factors with bacterial vaginosis (BV) BV prevalence n/N (%) Univariate OR (95% CI) Adjusted OR* (95% CI) E p i d e m i o l o g y *Adjusted for age, facility type, number of dependents, number of drinks per week, age at first sex, hormonal contraception and sex in the past 7 days; {data for vaginal cleansing are missing for 3 women. Data for inserting substances for sex are missing for 1 woman. Data for menstrual hygiene are missing for 15 women. Date of last menstrual period could not be remembered by 25 women. Results for Neisseria gonorrhoeae and Chlamydia trachomatis missing for 1 woman. Results for Trichomonas vaginalis and candidiasis missing for 4 women; {cleansing vagina or inserting substances for sex; 1among 469 women HIV positive; "among 914 women (445 HIV negative and 469 HIV positive). women. Only 5% reported inserting substances such as lemon or caustic soda to reduce lubrication during sex (dry sex). Although asked to avoid IVP before the clinic visit, 68% of women reported cleansing or inserting substances for sex in the previous 24 hours. Mean time since last IVP was 9.3 hours (range 1–24) for cleansing and 10.6 hours (4–24) for other IVP. Most women (78%) reported using cloths for menstrual protection; 4% reported using cotton wool. In the univariate analysis, BV was not associated with frequency or timing of vaginal cleansing nor the methods used Sex Transm Infect 2009;85:370–375. doi:10.1136/sti.2008.035543 373