Vaginal practices, microbicides and HIV: what do we need to know?

Document Type



Obstetrics and Gynaecology (East Africa)


The goal of a safer vaginal environment could be reached by identifying harmful vaginal practices and an effective microbicide, thereby increasing options for HIV prevention The global burden of HIV, its increasing feminisation, and chronic difficulties with development of options for HIV prevention all argue for an intensified re‐examination of factors influencing the efficiency of heterosexual HIV transmission. This includes vaginal practices and products used by large numbers of women worldwide to tighten, dry, warm and clean their vagina. Women's efforts to change their genital environment can undermine each component of innate defences against pathogens.1 In particular, vaginal practices have been linked with loss of lactobacilli and disruption of the vaginal epithelium.2,3,4 These practices may therefore be an important mediator in acquisition of STI, including HIV, or worsen pre‐existing infections. Despite this, surprisingly little is known about the effects of specific vaginal practices on HIV transmission dynamics.


This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

Sex Transm Infect.