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Assessing Intravaginal Practices in HIV Prevention Research: Development and Validation of an Intravaginal Practices Questionnaire

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Abstract

Intravaginal practices (IVPs) refer to placing items (e.g., water, soap, commercial douches, fingers, rags) inside the vagina. IVPs have been shown to contribute to the development of bacterial vaginosis (BV) and may increase sexually transmitted infections and HIV risk. We developed the Intravaginal Practices Questionnaire (IVQ). The purpose of this study was to validate the IVQ, with the goal of establishing a consistent method of assessing IVP across studies. Women enrolled in this study (n = 180) were on average 30 years of age (SD = 8.32). Half (54%) identified as non-Hispanic, and 45% identified as Black; 41% reported lifetime IVP. Past month IVP use included commercial douches (9%), water (35%), fingers (41%), soap (21%), cloths/rags/wipes (10%), and vinegar (3%), which were placed in the vagina. No women used yogurt or herbs. An exploratory factor analysis indicated that a single-factor structure best explained the underlying constructs in participant responses in six endorsed items assessing commercial douches, water, fingers, soap, clothes/rags/ wipes, and vinegar use, suggesting that a common factor underlies these behaviors. All factor loadings were > 0.496. Cronbach’s α was 0.99, suggesting that the reliability of the scale was excellent. Lastly, a total IVQ score was related to BV diagnosis (p = .007) as well as self-reported symptoms of BV (p = .034). Results illustrate that the IVQ has adequate psychometric properties. This tool may be used by public health experts and clinicians to identify IVPs that may potentially increase HIV risk.

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Funding

This work was supported by the National Institute of Allergy and Infectious Diseases (R01AI138718); the University of Miami Developmental HIV/AIDS Mental Health Research Center, which is funded by the National Institute of Mental Health of the National Institutes of Health under award number P30MH116867; and the Miami Center for AIDS Research (CFAR) at the University of Miami Miller School of Medicine of the National Institutes of Health under award number P30AI1073961, which is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMHD, NIA, NIDDK, NIDCR, NIMH, NINR, NIGMS, and OD. EMC’s work was supported by a National Institute of Allergy and Infectious Diseases (NIAID) Ruth L. Kirschstein Postdoctoral Individual National Research Service Award (1F32AI162229). VJR’s work on this study was partially supported by a Ford Foundation Fellowship, administered by the National Academies of Science, a PEO Scholar Award from the PEO Sisterhood, and a grant from the NIMH of the National Institutes of Health under Award Number R36MH127838. The funding agencies did not participate in the study design, data collection, analysis, decision to publish, or preparation of the manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA

    Violeta J. Rodriguez & Deborah L. Jones

  2. Department of Psychology, University of Georgia, Athens, GA, USA

    Violeta J. Rodriguez

  3. Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, 1951 NW 7th Ave, Suite 2300, Miami, FL, 33136, USA

    Ana S. Salazar & Maria L. Alcaide

  4. Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA

    Emily M. Cherenack

  5. Department of Surgery, Surgical Outcomes and Precision Medicine Research Division, University of Minnesota, Minneapolis, MN, USA

    Nichole R. Klatt

  6. Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, Miami, FL, USA

    Maria L. Alcaide

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  1. Violeta J. Rodriguez
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  2. Ana S. Salazar
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  3. Emily M. Cherenack
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  4. Nichole R. Klatt
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  5. Deborah L. Jones
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  6. Maria L. Alcaide
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Correspondence to Maria L. Alcaide.

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Ethical approval was received from institutional review board at the University of Miami Miller School of Medicine. All participants provided written informed consent.

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Rodriguez, V.J., Salazar, A.S., Cherenack, E.M. et al. Assessing Intravaginal Practices in HIV Prevention Research: Development and Validation of an Intravaginal Practices Questionnaire. Arch Sex Behav 52, 803–808 (2023). https://doi.org/10.1007/s10508-022-02484-4

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  • DOI: https://doi.org/10.1007/s10508-022-02484-4

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