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Abstract
Can harmful vaginal practices be modified? A meta ethnography
A. Martin Hilber1, E. Kenter2, S. Redmond3, S. Merten4, N. Low5, R. Garside6
Background: Some vaginal practices have been implicated as a potential facilitator of HIV transmission in women. In recent years, this research group has conducted a series of qual/quantitative studies to assess the nature, prevalence, and potential harm of such practices. To complement these studies, a meta-ethnography was conducted to investigate the meaning of vaginal practices for women in sub-Saharan Africa and their amenability to change through prevention efforts.
Methods: A meta-ethnography was conducted in 2008-2009. The literature search yielded over 2797 titles in the major databases; hand searches another 300 titles. Each title, abstract and selected full texts were reviewed in duplicate. 28 studies were selected for the analysis, 19 were summarized for their descriptive prevalence data, 17 were included in the meta-ethnographic synthesis. Analysis involved extraction of first order constructs (women's quotes); second order interpretations by the studies' authors; and finally, a third order synthesis of recurrent themes and concepts were developed by the reviewers.
Results: The synthesis shows how local constructs of gender, sexuality, health and illness influences women's preferred vaginal state and consequently, vaginal practices. Practices associated with sexuality often have their origin in cultural rites of passage, however their meaning and value has evolved over time and context. Negative consequences of modernization, for example, have increased women's dependency on vaginal practices to ensure economic security. While some vaginal practices appear to be cultural embedded, others are innovations that may be more amenable to change.
Conclusions: Early results of the quantitative systematic reviews identified specific practices which may be associated with harm. This meta-ethnography contextualizes the practices and suggests how they could be modified through public health initiatives. It also provides information on how to understand practices that may be affecting acceptability and adherence to microbicides.
5th IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
CDC089
Suggested Citation
"A.MartinHilber, et al.
Can harmful vaginal practices be modified? A meta ethnography .
:
5th IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
CDC089 "
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