All ETDs from UAB

Advisory Committee Chair

Diane M Grimley

Advisory Committee Members

Edward W Hook, Iii

Tina Y Simpson

Brad Lian

Stuart Usdan

Document Type

Dissertation

Date of Award

2009

Degree Name by School

Doctor of Philosophy (PhD) School of Public Health

Abstract

Current research suggests that up to 75% of American women have engaged in vaginal douching during their lives. Prevalence of the behavior is disproportionately high among minority women (especially African American) and women of low SES. Two bodies of research present conflicting results regarding the benefits or risks to reproductive health that are posed by vaginal douching, although the majority of research on this topic suggests that douching is associated with negative health outcomes. Although studies have suggested prevalence rates, behavioral correlates, and biological associations of vaginal douching, very few studies have used behavioral theory when examining the practice. The current research analyzed data from a national sample of 18- to 24-year-old women to gain a better understanding of the behavior throughout the nation. Results support previous research which suggests douching is practiced disproportionately by women with low educational attainment and African American women. Young women who report current douching are at higher risk for diagnosis with some STIs and gynecologic conditions and are at higher risk for using other feminine hygiene products which may compound the adverse outcomes already associated with vaginal douching. Regarding theoretical variables, never douchers had higher scores on cons of douching and lower scores on pros of douching (they were more likely to think of douching negatively than their currently douching counterparts). Younger and older women did not differ significantly regarding most indicators of general and reproductive health, although younger women were more likely than older women were to report they always used condoms during sex and went to the doctor more often. Future research should examine the shift in risk for vaginal douching from younger to older women, tailor interventions to the changing profile of women at risk for douching, and examine the theoretical context of vaginal douching with greater power.

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