Is vaginal washing associated with increased risk of HIV-1 acquisition?
McClelland and colleagues found an increased risk of HIV-acquisition for vaginal washing among 1270 Kenyan female sex workers participating in a 10-year open cohort study [adjusted hazard ratio (HR) for washing with water alone, 2.64, 95% confidence interval (CI), 1.00–6.97; and for soap 3.84, 95% CI, 1.51–9.77] . We also studied vaginal washing as a risk factor for HIV acquisition in a prospective cohort of 4531 women attending family planning clinics in Zimbabwe and Uganda, but did not find a statistically significant association (univariate HR for washing with water and/or soap 0.96, 95% CI, 0.72–1.27; unpublished data). Vaginal drying or tightening was associated with HIV-1 acquisition in univariate (HR, 1.49; 95% CI, 1.03–2.15) but not in multivariate models (HR, 1.09; 95% CI, 0.71–1.67). Our results are consistent with results of a South African study recently published by Meyer et al. .