Vaginal douching and vaginal substance use among sex workers in KwaZulu-Natal, South Africa

A local cultural practice that may enhance sexually transmitted infections (STIs) and HIV transmission is vaginal douching and vaginal substance use. These activities also have potential implications for the acceptability of HIV-prevention strategies such as the use of condoms and vaginal microbicides. We aimed to establish the prevalence, determinants and reasons for these practices among sex workers in KwaZulu-Natal, South Africa. A structured questionnaire was administered to 150 sex workers, who were being screened for a vaginal microbicide-effectiveness trial in the province. The questionnaire sought information on the frequency, reasons for and nature of vaginal douching and vaginal substance use and was drawn up on the basis of findings from a pilot study. Seventy per cent (95% CI: 62.0-77.2%) of the sex workers were HIV positive and on average they had five sexual partners per day. Vaginal douching and vaginal substance use were common among the sex workers. Vaginal douching was reported by 97% (n = 146) of the respondents and 94% reported vaginal substance use for 'dry sex'. A combination of traditional remedies, patent medicines, antiseptics and household detergents was used to clean and make the vagina dry and tight. The primary reasons reported for dry sex were to increase men's sexual pleasure (53%) and to attract clients and generate more money (20%). Sixty-five per cent of the women reported the practice of douching mainly for hygienic purposes and 13% for the prevention and treatment of sexually transmitted infections. Douching and dry-sex practices may increase women's risk of HIV and STI infection, and may have implications for the acceptability and development of HIV-prevention barrier methods such as microbicides and the use of condoms. These barrier methods may enhance or reduce sexual pleasure for men and women who engage in the practice of vaginal douching and vaginal substance use for 'dry sex'.

Diet and die,

Mode of access: Internet.

Ayer's American almanac : for the use of farmers, planters, mechanics, and all families ...

Issue for 1889 includes French, Spanish, Portuguese, Finnish, German, Dutch, Swedish, Norwegian-Danish, Bohemian, Welsh, and Italian sections.

Catalogue of medicinal plants and extracts : to which are affixed their most prominent medical properties : also essential oils, and double distilled fragrant waters /

Advertisements for "Compound fluid extract of Sarsaparilla" on p. [4] of wrapper.

Life among the Shakers.

"Location of the Societies": p. 6-7.

The story of the Shakers and some of their favorite cooking recipes : calendar for 1882.

"Presented by Mrs. Martha E. Partridge South Reading, Vt.": p. [36].

New favorite cooking receipts of the Shakers and illustrated almanac for '83 and '84 : the story of an accidental discovery.

Cf. Richmond, M.L.H. Shaker lit., 21.

Shaker almanac, 1884.

Image of the Statue of Liberty being erected on Bedloe's Island on p. [4] of cover.

Shaker almanac, 1885 : the joys and sorrows of a poor old man.

Imprint from Richmond, M.L.H. Shaker lit.

Shaker almanac, 1886 : the mystery explained.

Almanac features biographies and portraits of American millionaires.

How the Shakers cook and the noted cooks of the country.

Imprint from Richmond, M.L.H. Shaker lit.

Vanderbilt's candy church : the kings of the kitchen.

Published as advertisement for remedies manufactured by A.J. White, 168 Duane St., New York; includes short biographies of New York chefs.

Our common enemy: colds.

Mode of access: Internet.

Who Develops Innovations in Medicine for the Poor? Trends in Patent Applications Related to Medicines for HIV/AIDS, Tuberculosis, Malaria and Neglected Diseases

Who invents medicines for the poor of the world? This question becomes very important where the WTO allows low income countries to be unbound by the TRIPS agreement. This agreement concerns medicines for infectious diseases such as HIV/AIDS, tuberculosis and malaria. These diseases cause serious damage to low income countries. Under these circumstances, some scholars wonder if anyone will continue innovative activities related to treating these diseases. This paper sought to answer this question by collecting and analyzing patent data of medicines and vaccines for diseases using the database of the Japan Patent Office. Results indicate that private firms have led in innovation not only for global diseases such as HIV/AIDS but also diseases such as malaria that are spreading exclusively in low income countries. Innovation for the three infectious diseases is diverse among firms, and frequent patent applications by high-performing pharmaceutical firms appear prominent even after R&D expenditure, economies of scale, and economies of scope are taken into account.