Prevalence and motivations of vaginal practices in Tete Province, Mozambique

Abstract

Vaginal practices have been linked with an increase in risk for HIV transmission and other harms. In 2007, a household survey of 919 women was conducted in Tete province, Mozambique, as part of the World Health Organization Multicountry Study on Gender, Sexuality, and Vaginal Practices. Women aged 18 to 60 years old were interviewed to determine prevalence and motivations for vaginal practices. A large range of frequently used practices was identified. Nearly 80% of women reported three or more current practices, and virtually all had used at least three practices in their lifetime. Elongation of the vaginal labia minora was universal (99% of women), while a quarter stated they had made small vaginal cuts or incisions at least once. Ninety-two percent of women also reported ever use of intravaginal cleansing, and insertion of substances in the vagina was practiced by 72%. Around half (48%) reported ingestion of substances to affect the vagina, mostly to heat, tighten, or loosen the vagina. Application of substances on the genitalia (16%) and steaming (15%) were less popular. To prepare for sexual intercourse, women reported products were commonly applied, ingested, inserted, or steamed. Pregnancy, delivery, and postpartum were also associated with ingestion (26%), steaming (39%), and cutting (32%). Adoption of microbicides and condom use may be influenced by vaginal practices. HIV-prevention messages and interventions, including future microbicides, need to take into account the high prevalence of vaginal practices and motivations for their use. Further attention needs to be given to potentially harmful practices in HIV-prevention efforts in Mozambique.