Intravaginal practices are associated with greater odds of high-risk HPV infection in Haitian women

Julia Seay, Morgan Mandigo, Jonathan Kish, Janelle Menard, Sarah Marsh, Erin Kobetz

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: Haitian women have the highest incidence of cervical cancer within the Western hemisphere. Intravaginal hygiene practices have been linked with human papilloma virus (HPV) infection and cervical dysplasia. These practices, known as ‘twalet deba’ in Haitian Creole, are common among Haitian women and are performed with various natural and synthetic agents. As part of a community-based participatory research initiative aimed at reducing cervical cancer disparities in rural Haiti, we explored the use of intravaginal agents and their associations with high-risk HPV infection. Design: Community Health Workers recruited 416 women for cervical self-sampling from two neighborhoods within Thomonde, Haiti. Participants were interviewed regarding intravaginal hygiene practices and completed a cervical self-sampling procedure. Cervical samples were analyzed for the presence of high-risk HPV infection. Associations between each intravaginal agent and high-risk HPV infection were examined via univariate logistic regression analyses, as well as via multivariate analyses controlling for sociodemographic factors and concurrent agent use. Results: Nearly all women (97.1%) performed twalet deba, using a variety of herbal and commercially produced intravaginal agents. Approximately 11% of the participants tested positive for high-risk HPV. Pigeon pea and lime juice were the only agents found to be associated with high-risk HPV in the univariate analyses, with women who used these agents being approximately twice as likely to have high-risk HPV as those who did not. Only pigeon pea remained significantly associated with high-risk HPV after controlling for sociodemographic factors and concurrent agent use. Conclusion: Two agents, pigeon pea and lime juice, may contribute to risk for HPV infection in this population. Results suggest that in addition to cervical cancer screening interventions, future preventive initiatives should focus on minimizing risk by advocating for the use of less-toxic twalet deba alternatives.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalEthnicity and Health
DOIs
StateAccepted/In press - Oct 26 2016

Fingerprint

Papillomaviridae
Virus Diseases
Peas
Columbidae
Uterine Cervical Neoplasms
Haiti
sociodemographic factors
cancer
hygiene
Hygiene
Community-Based Participatory Research
Uterine Cervical Dysplasia
Virus
Infection
Poisons
Early Detection of Cancer
community

Keywords

  • cervical cancer
  • Haitian women
  • HPV
  • Intravaginal practices

ASJC Scopus subject areas

  • Cultural Studies
  • Arts and Humanities (miscellaneous)
  • Public Health, Environmental and Occupational Health

Cite this

Intravaginal practices are associated with greater odds of high-risk HPV infection in Haitian women. / Seay, Julia; Mandigo, Morgan; Kish, Jonathan; Menard, Janelle; Marsh, Sarah; Kobetz, Erin.

In: Ethnicity and Health, 26.10.2016, p. 1-9.

Research output: Contribution to journalArticle

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abstract = "Objective: Haitian women have the highest incidence of cervical cancer within the Western hemisphere. Intravaginal hygiene practices have been linked with human papilloma virus (HPV) infection and cervical dysplasia. These practices, known as ‘twalet deba’ in Haitian Creole, are common among Haitian women and are performed with various natural and synthetic agents. As part of a community-based participatory research initiative aimed at reducing cervical cancer disparities in rural Haiti, we explored the use of intravaginal agents and their associations with high-risk HPV infection. Design: Community Health Workers recruited 416 women for cervical self-sampling from two neighborhoods within Thomonde, Haiti. Participants were interviewed regarding intravaginal hygiene practices and completed a cervical self-sampling procedure. Cervical samples were analyzed for the presence of high-risk HPV infection. Associations between each intravaginal agent and high-risk HPV infection were examined via univariate logistic regression analyses, as well as via multivariate analyses controlling for sociodemographic factors and concurrent agent use. Results: Nearly all women (97.1{\%}) performed twalet deba, using a variety of herbal and commercially produced intravaginal agents. Approximately 11{\%} of the participants tested positive for high-risk HPV. Pigeon pea and lime juice were the only agents found to be associated with high-risk HPV in the univariate analyses, with women who used these agents being approximately twice as likely to have high-risk HPV as those who did not. Only pigeon pea remained significantly associated with high-risk HPV after controlling for sociodemographic factors and concurrent agent use. Conclusion: Two agents, pigeon pea and lime juice, may contribute to risk for HPV infection in this population. Results suggest that in addition to cervical cancer screening interventions, future preventive initiatives should focus on minimizing risk by advocating for the use of less-toxic twalet deba alternatives.",
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