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Prevalence of HIV and other sexually transmitted infections in relation to lemon/lime juice douching among female sex workers in Jos, North Central Nigeria
Presented by Godwin Imade, Nigeria.
Imade G.1, Sagay A.1, Egah D.2, Onwuliri V.3, Grigg M.4, Egbodo C.1, Thacher T.5, Potts M.6, Short R.4
1University of Jos/Jos University Teaching Hospital, Dept of Obstetrics and Gynaecology, Jos, Nigeria, 2University of Jos/Jos University Teaching Hospital, Dept of Medical Microbiology, Jos, Nigeria, 3University of Jos, Dept of Biochemistry, Jos, Nigeria, 4University of Melbourne, Faculty of Medicine, Melbourne, Australia, 5Jos University Teaching Hospital, Dept of Family Medicine, Jos, Nigeria, 6University of California, School of Public Health, Berkeley, Calfornia, United States
Objectives: The rates of STIs including HIV are high among FSW in Nigeria and the use of various local vaginal cleansing agents to prevent infection is a common practice. This study was aimed at determining whether lime/lemon juice douching is protective or promotes the spread of STIs/HIV among FSW in Jos, Nigeria.
Methods: Consenting FSW who were Users of lime/lemon (UL) and Non-Users (NUL) were recruited for the study between May and September 2006. A Structured questionnaire was administered by trained counsellors. Pre-HIV test counselling was done. Participant’s blood samples were tested for HIV, Syphilis, Hepatitis B and C. Genital examination; high vaginal and endocervical samples were collected. The samples obtained were processed for STIs using standard laboratory procedures. FSW found with treatable STI received free drugs. HIV results were disclosed after post-test counselling and positive FSWs were referred to a HIV/AIDS facility for antiretroviral therapy, care and support.
Results: 398 FSW (86 ULs and 312 NULs) participated in the study. Their mean age was 27.6±7.0 (range 15-63) years. HIV prevalence for UL and NUL were 48.8% and 48.2% respectively (OR 1.0; 95% CI 0.6-1.2, p=0.9427). The rates of B. vaginosis (UL 55.8%, NUL 44%, OR 1.59, 95% CI 0.96-2.65, p=0.06) which appeared to show association with lemon usage did not reach a statistically significant level. There were no associations between use of citrus douching and other STIs.
Conclusions: There were no significant differences in infection rates between ULs and NULs. Lemon/lime usage did not appear to have any impact on HIV/STI acquisition by sex workers. The study was unable to control for frequency of condom use, timing of douching, volume of citrus juice used or degree of dilution. A standardised prospective study among existing lime/lemon users is required to justify the promotion or rejection of the agent.
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