Exploring intravaginal practices among Haitian women as a risk factor for adverse sexual and reproductive health outcomes
Abstract Authors
Dominique Guillaume (1,2), Maria L. Alcaide (3), Candice Sternberg (3), Ann Augustin (4), Natalie Pierre-Joseph (5), Kamila Alexander (1)
Author Affiliations
1. Johns Hopkins University, Baltimore, MD 2. Jhpiego, Baltimore, MD 3. University of Miami Miller School of Medicine, Miami, FL 4. University of Miami, Miami, FL 5. Boston University School of Medicine, Boston, MA
Background
Haiti has the highest incidence rates of HIV and cervical cancer in the Caribbean. This burden of HIV and cervical cancer is also reflected amongst Haitian migrants in the United States. Intravaginal practices involving plants, herbs, chemicals, and other agents are commonly used among Haitian women for maintenance of their gynecological health. Recent studies have noted that such practices can significantly alter the vaginal microbiome, and result in a higher predisposition towards Human Papillomavirus (HPV) acquisition - the primary stage towards developing cervical cancer - along with other sexually transmitted infections (STIs) and HIV. The data that we report is part of a larger ongoing study investigating cultural drivers of HPV and cervical cancer risk perception among Haitian women, and explores traditional health practices commonly used by Haitian women for their gynecological health.
Methods
This qualitative descriptive study utilized convenience sampling from community-based centers in Little Haiti, Miami to recruit Haitian women who migrated within the last two years . Semi-structured in-depth interviews explored HPV and HIV awareness, disease perceptions , and cultural practices influencing health behaviors. Interviews were conducted in Haitian Creole and transcribed by hand. Atlas.ti software was used for thematic analysis, in which open codes were categorized into broader themes.
Results
A total of N=25 newly arrived Haitian migrants (18-45 years old) participated in the study. Most women voiced HIV as a primary disease of concern, and perceived HIV as a more severe condition than cervical cancer . All women reported intravaginal use of plants, herbs, or chemical products. Women used these products for varying reasons including after labor, during one’s menstrual cycle, in the presence of symptoms of a vaginal infection, and to enhance men’s pleasure. Women were less likely to present to medical facilities for gynecological care, and often used plants and herbs for their ailments. Women often started these practices after puberty prior to sexual debut.
Conclusion(s)
Understanding Haitian women’s cultural practices is critical in addressing sexual and reproductive health issues in this priority community. A better understanding of Haitian women’s vaginal microbiome is needed to estimate the impact of these practices on women’s STI and HIV risk.