Finally, the CSWs were taken to a clinic for pelvic examination, endocervical and high vaginal swabs, the Papanicouleaua (pap) smear and venous blood sampling for HIV screening. Exclusion criteria were the use of barrier and hormonal contraceptives and the use of other douching methods, such as medicated creams, lotions or soaps. Simple random sampling was used to select brothels in each of the communities studied, with the leader of the CSWs in each brothel also randomly selecting the CSWs for the interview.
12 This study was conducted between 04 and 30 July 2008.Ī sample of 194 CSWs were randomly selected and interviewed, both in formal (brothel) and informal settlements in the three LGAs. Maiduguri Metropolitan Council is the state capital, while Ngala and Askira/Uba are two border towns with significant numbers of CSWs. This study was conducted in three LGAs: the Metropolitan Council of Maiduguri, Ngala and Askira/Uba, representing the three senatorial zones of Borno State, Nigeria. Baga, Ngala and Askira/Uba), were not included in the survey. However, this prevalence rate of 3.2% is not realistic as hot-spot areas, such as border towns 12 (e.g.
11 The HIV/AIDS prevalence has been fluctuating from 4.5% to 5.4% the current 2003 sentinel survey amongst women attending ante-natal clinics indicated the prevalence at 3.2%. Only 2% of women in this region are said to be using modern contraceptives. The crude birth rate is 43., the gross fertility rate is 1 and the maternal mortality ratio is 1549 per 100 000 live births. The state is rich with various cultures, norms and values, with the popular occupations of Borno citizenry including farming, fishing and trading.Īvailable statistics show that the reproductive health situations in this area are the worst, compared to that of any other part of Nigeria. The principal tribes of the state are the Kanuri, followed by the Babur, Bura, Marghi, Shuwa Arabs, Fulani and the Hausa. 10 Islam is the major religion, followed by Christianity. The state covers an area of 69 436 km 2 and has a population of 4 151 193 (according to the 2006 national population census), with 64.37% of the populace living in rural areas and 35.63% in urban. There are 27 local government areas (LGAs) in the state and Maiduguri is the state capital. Within Nigeria, it shares borders with Yobe, Adamawa and Gombe States to the north-west and south, respectively. The state occupies a greater part of the Chad Basin area borders three African countries, namely, Niger to the north, Chad to the north-east and Cameroon to the east. 9 This study was therefore undertaken to determine the extent of, reasons for, and the reproductive health effects of, lime juice use for vaginal douching among the CSWs in selected areas of the three senatorial regions of Borno State, Nigeria.īorno State is one of the 36 states of the Federal Republic of Nigeria and is located in the north-eastern corner of the country. 6– 8Īnecdotal information from health workers within Borno State, Nigeria reports that a significant number of female commercial sex workers (CSWs) in the area douched with lime juice before or after sexual intercourse. Increasingly, evidence also suggests some adverse reproductive health effects of vaginal douching agents (including lime juice), which includes increased risks of bacterial vaginosis, HIV infection, pelvic inflammatory disease (PID) and cervical cancer. 1– 4 Its contraceptive effectiveness has also been reported. Vaginal cleansing before or after, or between, the act of intercourse is thought to treat gynaecological diseases, prevent sexually transmitted infections and restore and tighten the vagina after delivery. 2 Vaginal douching with lime juice has been perceived among women to enhance sexual excitement through sensations of vaginal dryness, tightness or warmth. 1 It is a particularly common practice among both married women (who are not sex workers) and female sex workers in many parts of sub-Saharan Africa. Vaginal douching is a global traditional practice dating back hundreds of years, with the perception that it enhances sexual pleasure.
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