Intravaginal Practices, Bacterial Vaginosis, and HIV Infection in Women: Individual Participant Data Meta-analysis
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{"title"=>"Intravaginal practices, bacterial vaginosis, and HIV infection in women: Individual participant data meta-analysis", "type"=>"journal", "authors"=>[{"first_name"=>"Nicola", "last_name"=>"Low", "scopus_author_id"=>"7006432437"}, {"first_name"=>"Matthew F.", "last_name"=>"Chersich", "scopus_author_id"=>"57195727925"}, {"first_name"=>"Kurt", "last_name"=>"Schmidlin", "scopus_author_id"=>"24476651100"}, {"first_name"=>"Matthias", "last_name"=>"Egger", "scopus_author_id"=>"34768019000"}, {"first_name"=>"Suzanna C.", "last_name"=>"Francis", "scopus_author_id"=>"25227484500"}, {"first_name"=>"Janneke H.H.M.", "last_name"=>"van de Wijgert", "scopus_author_id"=>"6602887266"}, {"first_name"=>"Richard J.", "last_name"=>"Hayes", "scopus_author_id"=>"7402082478"}, {"first_name"=>"Jared M.", "last_name"=>"Baeten", "scopus_author_id"=>"7003812564"}, {"first_name"=>"Joelle", "last_name"=>"Brown", "scopus_author_id"=>"9239405100"}, {"first_name"=>"Sinead", "last_name"=>"Delany-Moretlwe", "scopus_author_id"=>"56032229400"}, {"first_name"=>"Rupert", "last_name"=>"Kaul", "scopus_author_id"=>"7103098610"}, {"first_name"=>"Nuala", "last_name"=>"McGrath", "scopus_author_id"=>"16069002500"}, {"first_name"=>"Charles", "last_name"=>"Morrison", "scopus_author_id"=>"7201897940"}, {"first_name"=>"Landon", "last_name"=>"Myer", "scopus_author_id"=>"7006272201"}, {"first_name"=>"Marleen", "last_name"=>"Temmerman", "scopus_author_id"=>"7006553571"}, {"first_name"=>"Ariane", "last_name"=>"van der Straten", "scopus_author_id"=>"7003900653"}, {"first_name"=>"Deborah", "last_name"=>"Watson-Jones", "scopus_author_id"=>"55964647500"}, {"first_name"=>"Marcel", "last_name"=>"Zwahlen", "scopus_author_id"=>"7004748418"}, {"first_name"=>"Adriane", "last_name"=>"Hilber", "scopus_author_id"=>"36051714900"}], "year"=>2011, "source"=>"PLoS Medicine", "identifiers"=>{"pmid"=>"21358808", "doi"=>"10.1371/journal.pmed.1000416", "sgr"=>"79952264089", "isbn"=>"1549-1676 (Electronic)\\n1549-1277 (Linking)", "scopus"=>"2-s2.0-79952264089", "issn"=>"15491277", "pui"=>"361373967"}, "id"=>"535dc0e5-9071-3881-8334-abe2ed43b646", "abstract"=>"BACKGROUND: Identifying modifiable factors that increase women's vulnerability to HIV is a critical step in developing effective female-initiated prevention interventions. The primary objective of this study was to pool individual participant data from prospective longitudinal studies to investigate the association between intravaginal practices and acquisition of HIV infection among women in sub-Saharan Africa. Secondary objectives were to investigate associations between intravaginal practices and disrupted vaginal flora; and between disrupted vaginal flora and HIV acquisition.\\n\\nMETHODS AND FINDINGS: We conducted a meta-analysis of individual participant data from 13 prospective cohort studies involving 14,874 women, of whom 791 acquired HIV infection during 21,218 woman years of follow-up. Data were pooled using random-effects meta-analysis. The level of between-study heterogeneity was low in all analyses (I(2) values 0.0%-16.1%). Intravaginal use of cloth or paper (pooled adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.18-1.83), insertion of products to dry or tighten the vagina (aHR 1.31, 95% CI 1.00-1.71), and intravaginal cleaning with soap (aHR 1.24, 95% CI 1.01-1.53) remained associated with HIV acquisition after controlling for age, marital status, and number of sex partners in the past 3 months. Intravaginal cleaning with soap was also associated with the development of intermediate vaginal flora and bacterial vaginosis in women with normal vaginal flora at baseline (pooled adjusted odds ratio [OR] 1.24, 95% CI 1.04-1.47). Use of cloth or paper was not associated with the development of disrupted vaginal flora. Intermediate vaginal flora and bacterial vaginosis were each associated with HIV acquisition in multivariable models when measured at baseline (aHR 1.54 and 1.69, p<0.001) or at the visit before the estimated date of HIV infection (aHR 1.41 and 1.53, p<0.001), respectively.\\n\\nCONCLUSIONS: This study provides evidence to suggest that some intravaginal practices increase the risk of HIV acquisition but a direct causal pathway linking intravaginal cleaning with soap, disruption of vaginal flora, and HIV acquisition has not yet been demonstrated. More consistency in the definition and measurement of specific intravaginal practices is warranted so that the effects of specific intravaginal practices and products can be further elucidated. Please see later in the article for the Editors' Summary.", "link"=>"http://www.mendeley.com/research/intravaginal-practices-bacterial-vaginosis-hiv-infection-women-individual-participant-data-metaanaly-2", "reader_count"=>90, "reader_count_by_academic_status"=>{"Unspecified"=>4, "Professor > Associate Professor"=>2, "Librarian"=>2, "Researcher"=>22, "Student > Doctoral Student"=>5, "Student > Ph. D. Student"=>16, "Student > Postgraduate"=>5, "Student > Master"=>17, "Other"=>4, "Student > Bachelor"=>7, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>3, "Professor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>4, "Professor > Associate Professor"=>2, "Librarian"=>2, "Researcher"=>22, "Student > Doctoral Student"=>5, "Student > Ph. D. Student"=>16, "Student > Postgraduate"=>5, "Student > Master"=>17, "Other"=>4, "Student > Bachelor"=>7, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>3, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>10, "Environmental Science"=>2, "Nursing and Health Professions"=>5, "Medicine and Dentistry"=>43, "Agricultural and Biological Sciences"=>10, "Arts and Humanities"=>1, "Philosophy"=>1, "Psychology"=>1, "Social Sciences"=>10, "Computer Science"=>2, "Immunology and Microbiology"=>4, "Chemistry"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>43}, "Chemistry"=>{"Chemistry"=>1}, "Social Sciences"=>{"Social Sciences"=>10}, "Psychology"=>{"Psychology"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>4}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>10}, "Computer Science"=>{"Computer Science"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>5}, "Unspecified"=>{"Unspecified"=>10}, "Environmental Science"=>{"Environmental Science"=>2}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Philosophy"=>{"Philosophy"=>1}}, "reader_count_by_country"=>{"United States"=>1}, "group_count"=>11}

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  • {"files"=>["https://ndownloader.figshare.com/files/399198", "https://ndownloader.figshare.com/files/399232", "https://ndownloader.figshare.com/files/399261", "https://ndownloader.figshare.com/files/399282"], "description"=>"<div><h3>Background</h3><p>Identifying modifiable factors that increase women's vulnerability to HIV is a critical step in developing effective female-initiated prevention interventions. The primary objective of this study was to pool individual participant data from prospective longitudinal studies to investigate the association between intravaginal practices and acquisition of HIV infection among women in sub-Saharan Africa. Secondary objectives were to investigate associations between intravaginal practices and disrupted vaginal flora; and between disrupted vaginal flora and HIV acquisition.</p><h3>Methods and Findings</h3><p>We conducted a meta-analysis of individual participant data from 13 prospective cohort studies involving 14,874 women, of whom 791 acquired HIV infection during 21,218 woman years of follow-up. Data were pooled using random-effects meta-analysis. The level of between-study heterogeneity was low in all analyses (<em>I</em><sup>2</sup> values 0.0%–16.1%). Intravaginal use of cloth or paper (pooled adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.18–1.83), insertion of products to dry or tighten the vagina (aHR 1.31, 95% CI 1.00–1.71), and intravaginal cleaning with soap (aHR 1.24, 95% CI 1.01–1.53) remained associated with HIV acquisition after controlling for age, marital status, and number of sex partners in the past 3 months. Intravaginal cleaning with soap was also associated with the development of intermediate vaginal flora and bacterial vaginosis in women with normal vaginal flora at baseline (pooled adjusted odds ratio [OR] 1.24, 95% CI 1.04–1.47). Use of cloth or paper was not associated with the development of disrupted vaginal flora. Intermediate vaginal flora and bacterial vaginosis were each associated with HIV acquisition in multivariable models when measured at baseline (aHR 1.54 and 1.69, <em>p</em><0.001) or at the visit before the estimated date of HIV infection (aHR 1.41 and 1.53, <em>p</em><0.001), respectively.</p><h3>Conclusions</h3><p>This study provides evidence to suggest that some intravaginal practices increase the risk of HIV acquisition but a direct causal pathway linking intravaginal cleaning with soap, disruption of vaginal flora, and HIV acquisition has not yet been demonstrated. More consistency in the definition and measurement of specific intravaginal practices is warranted so that the effects of specific intravaginal practices and products can be further elucidated.</p><h3></h3><p><em>Please see later in the article for the Editors' Summary</em></p></div>", "links"=>[], "tags"=>["intravaginal", "bacterial", "hiv", "meta-analysis"], "article_id"=>138845, "categories"=>["Neuroscience", "Biological Sciences", "Medicine"], "users"=>["Nicola Low", "Matthew F. Chersich", "Kurt Schmidlin", "Matthias Egger", "Suzanna C. Francis", "Janneke H. H. M. van de Wijgert", "Richard J. Hayes", "Jared M. Baeten", "Joelle Brown", "Sinead Delany-Moretlwe", "Rupert Kaul", "Nuala McGrath", "Charles Morrison", "Landon Myer", "Marleen Temmerman", "Ariane van der Straten", "Deborah Watson-Jones", "Marcel Zwahlen", "Adriane Martin Hilber"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000416.s001", "https://dx.doi.org/10.1371/journal.pmed.1000416.s002", "https://dx.doi.org/10.1371/journal.pmed.1000416.s003", "https://dx.doi.org/10.1371/journal.pmed.1000416.s004"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Intravaginal_Practices_Bacterial_Vaginosis_and_HIV_Infection_in_Women_Individual_Participant_Data_Meta_analysis/138845", "title"=>"Intravaginal Practices, Bacterial Vaginosis, and HIV Infection in Women: Individual Participant Data Meta-analysis", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2011-02-15 02:27:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/798243"], "description"=>"<p>Flow diagram of included studies.</p>", "links"=>[], "tags"=>["diagram", "included"], "article_id"=>468590, "categories"=>["Neuroscience", "Computational Biology", "Medicine"], "users"=>["Nicola Low", "Matthew F. Chersich", "Kurt Schmidlin", "Matthias Egger", "Suzanna C. Francis", "Janneke H. H. M. van de Wijgert", "Richard J. Hayes", "Jared M. Baeten", "Joelle Brown", "Sinead Delany-Moretlwe", "Rupert Kaul", "Nuala McGrath", "Charles Morrison", "Landon Myer", "Marleen Temmerman", "Ariane van der Straten", "Deborah Watson-Jones", "Marcel Zwahlen", "Adriane Martin Hilber"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000416.g001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_diagram_of_included_studies_/468590", "title"=>"Flow diagram of included studies.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-02-15 02:23:10"}
  • {"files"=>["https://ndownloader.figshare.com/files/798344"], "description"=>"<p>Individual study results from Cox regression. Pooled unadjusted and aHRs from random effects meta-analysis. Reference group is women who reported no intravaginal practice or cleaning with water only. Multivariable models adjusted for age, marital status, and number of partners in last 3 mo. No estimate possible if there were no events in one group.</p>", "links"=>[], "tags"=>["vagina", "products", "hiv", "ordered"], "article_id"=>468692, "categories"=>["Neuroscience", "Computational Biology", "Medicine"], "users"=>["Nicola Low", "Matthew F. Chersich", "Kurt Schmidlin", "Matthias Egger", "Suzanna C. Francis", "Janneke H. H. M. van de Wijgert", "Richard J. Hayes", "Jared M. Baeten", "Joelle Brown", "Sinead Delany-Moretlwe", "Rupert Kaul", "Nuala McGrath", "Charles Morrison", "Landon Myer", "Marleen Temmerman", "Ariane van der Straten", "Deborah Watson-Jones", "Marcel Zwahlen", "Adriane Martin Hilber"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000416.g002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Association_between_use_of_cloth_or_paper_to_wipe_out_vagina_or_apply_products_and_HIV_acquisition_ordered_by_country_north_to_south_n_10_332_/468692", "title"=>"Association between use of cloth or paper to wipe out vagina or apply products and HIV acquisition, ordered by country, north to south (<i>n</i> = 10,332).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-02-15 02:24:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/798479"], "description"=>"<p>Individual study results from Cox regression. Pooled unadjusted and aHRs from random effects meta-analysis. Reference group is women who reported no intravaginal practice or cleaning with water only. Multivariable models adjusted for age, marital status, and number of partners in last 3 mo.</p>", "links"=>[], "tags"=>["intravaginal", "cleaning", "hiv", "ordered"], "article_id"=>468826, "categories"=>["Neuroscience", "Computational Biology", "Medicine"], "users"=>["Nicola Low", "Matthew F. Chersich", "Kurt Schmidlin", "Matthias Egger", "Suzanna C. Francis", "Janneke H. H. M. van de Wijgert", "Richard J. Hayes", "Jared M. Baeten", "Joelle Brown", "Sinead Delany-Moretlwe", "Rupert Kaul", "Nuala McGrath", "Charles Morrison", "Landon Myer", "Marleen Temmerman", "Ariane van der Straten", "Deborah Watson-Jones", "Marcel Zwahlen", "Adriane Martin Hilber"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000416.g003"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Association_between_intravaginal_cleaning_with_soap_and_HIV_acquisition_ordered_by_country_north_to_south_n_3_071_/468826", "title"=>"Association between intravaginal cleaning with soap and HIV acquisition, ordered by country, north to south (<i>n</i> = 3,071).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-02-15 02:27:06"}
  • {"files"=>["https://ndownloader.figshare.com/files/798576"], "description"=>"<p>Individual study results from Cox regression. Pooled unadjusted and aHRs from random effects meta-analysis. Reference group is women who reported no intravaginal practice or cleaning with water only. Multivariable models adjusted for age, marital status, and number of partners in last 3 mo. No estimate possible if there were no events in one group. Stratum excluded if there were no events in either group, or standard error could not be estimated by model.</p>", "links"=>[], "tags"=>["insertion", "products", "vagina", "hiv", "ordered"], "article_id"=>468922, "categories"=>["Neuroscience", "Computational Biology", "Medicine"], "users"=>["Nicola Low", "Matthew F. Chersich", "Kurt Schmidlin", "Matthias Egger", "Suzanna C. Francis", "Janneke H. H. M. van de Wijgert", "Richard J. Hayes", "Jared M. Baeten", "Joelle Brown", "Sinead Delany-Moretlwe", "Rupert Kaul", "Nuala McGrath", "Charles Morrison", "Landon Myer", "Marleen Temmerman", "Ariane van der Straten", "Deborah Watson-Jones", "Marcel Zwahlen", "Adriane Martin Hilber"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000416.g004"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Association_between_insertion_of_products_to_dry_or_tighten_the_vagina_and_HIV_acquisition_ordered_by_country_north_to_south_n_9_420_/468922", "title"=>"Association between insertion of products to dry or tighten the vagina and HIV acquisition, ordered by country, north to south(<i>n</i> = 9,420).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-02-15 02:28:42"}
  • {"files"=>["https://ndownloader.figshare.com/files/798723"], "description"=>"<p>Individual study results from Cox regression. Pooled unadjusted and aHRs from random effects meta-analysis. Reference group is women who reported no intravaginal practice or cleaning with water only. Multivariable models adjusted for age, marital status, and number of partners in last 3 mo. No estimate possible if there were no events in one group.</p>", "links"=>[], "tags"=>["intravaginal", "cleaning", "cleaners", "hiv", "ordered"], "article_id"=>469070, "categories"=>["Neuroscience", "Computational Biology", "Medicine"], "users"=>["Nicola Low", "Matthew F. Chersich", "Kurt Schmidlin", "Matthias Egger", "Suzanna C. Francis", "Janneke H. H. M. van de Wijgert", "Richard J. Hayes", "Jared M. Baeten", "Joelle Brown", "Sinead Delany-Moretlwe", "Rupert Kaul", "Nuala McGrath", "Charles Morrison", "Landon Myer", "Marleen Temmerman", "Ariane van der Straten", "Deborah Watson-Jones", "Marcel Zwahlen", "Adriane Martin Hilber"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000416.g005"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Association_between_intravaginal_cleaning_with_household_cleaners_and_HIV_acquisition_ordered_by_country_north_to_south_n_8_879_/469070", "title"=>"Association between intravaginal cleaning with household cleaners and HIV acquisition, ordered by country, north to south (<i>n</i> = 8,879).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-02-15 02:31:10"}
  • {"files"=>["https://ndownloader.figshare.com/files/798815"], "description"=>"<p>OR from two-stage random effects meta-analysis based on ordered logistic regression.</p>a<p>Baseline category for intravaginal practices is no vaginal practice or use of water only. Intravaginal practices measured at baseline.</p>b<p>Disrupted vaginal flora as a three-level ordered categorical variable: normal vaginal flora defined as Nugent score 0–3, or Ison-Hay grade I; intermediate vaginal flora defined as Nugent score 4–6, or Ison-Hay grade II; BV defined as Nugent score 7–10, or Ison-Hay grade III. Excludes two studies that did not use Gram stain criteria <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000416#pmed.1000416-Kumwenda1\" target=\"_blank\">[19]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000416#pmed.1000416-Myer3\" target=\"_blank\">[20]</a>.</p>c<p>Number with normal flora at baseline who developed disrupted vaginal flora includes both women using and not using each intravaginal practice.</p>d<p>Adjusted for age, marital status, and reported number of sex partners in last 3 mo as reported at cohort entry.</p>", "links"=>[], "tags"=>["intravaginal", "practices", "disrupted", "vaginal", "flora", "women"], "article_id"=>469152, "categories"=>["Neuroscience", "Computational Biology", "Medicine"], "users"=>["Nicola Low", "Matthew F. Chersich", "Kurt Schmidlin", "Matthias Egger", "Suzanna C. Francis", "Janneke H. H. M. van de Wijgert", "Richard J. Hayes", "Jared M. Baeten", "Joelle Brown", "Sinead Delany-Moretlwe", "Rupert Kaul", "Nuala McGrath", "Charles Morrison", "Landon Myer", "Marleen Temmerman", "Ariane van der Straten", "Deborah Watson-Jones", "Marcel Zwahlen", "Adriane Martin Hilber"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000416.t004"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Associations_between_intravaginal_practices_and_disrupted_vaginal_flora_in_women_with_normal_vaginal_flora_at_baseline_/469152", "title"=>"Associations between intravaginal practices and disrupted vaginal flora in women with normal vaginal flora at baseline.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-02-15 02:32:32"}
  • {"files"=>["https://ndownloader.figshare.com/files/798871"], "description"=>"a<p>Included in analysis are women with available vaginal flora status measured by Gram stain criteria: normal vaginal flora defined as Nugent score 0–3, or Ison-Hay grade I; intermediate vaginal flora defined as Nugent score 4–6, or Ison-Hay grade II; BV defined as Nugent score 7–10, or Ison-Hay grade III. Excludes two studies that did not use Gram stain criteria <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000416#pmed.1000416-Kumwenda1\" target=\"_blank\">[19]</a>,<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000416#pmed.1000416-Myer3\" target=\"_blank\">[20]</a>.</p>b<p>Multivariable model controls for all variables in the table.</p>", "links"=>[], "tags"=>["disrupted", "vaginal", "flora", "hiv", "stratified", "cox"], "article_id"=>469208, "categories"=>["Neuroscience", "Computational Biology", "Medicine"], "users"=>["Nicola Low", "Matthew F. Chersich", "Kurt Schmidlin", "Matthias Egger", "Suzanna C. Francis", "Janneke H. H. M. van de Wijgert", "Richard J. Hayes", "Jared M. Baeten", "Joelle Brown", "Sinead Delany-Moretlwe", "Rupert Kaul", "Nuala McGrath", "Charles Morrison", "Landon Myer", "Marleen Temmerman", "Ariane van der Straten", "Deborah Watson-Jones", "Marcel Zwahlen", "Adriane Martin Hilber"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000416.t005"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Association_between_disrupted_vaginal_flora_and_HIV_acquisition_stratified_Cox_regression_/469208", "title"=>"Association between disrupted vaginal flora and HIV acquisition, stratified Cox regression.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-02-15 02:33:28"}
  • {"files"=>["https://ndownloader.figshare.com/files/798932"], "description"=>"a<p>Includes any intravaginal practice reported at the baseline visit.</p>b<p>Water is the only substance put into the vagina and woman does not use any other intravaginal practice (this category was grouped with “no intravaginal practice” to form the reference category for comparative analyses).</p>c<p>Woman reports using this practice and may or may not report any other intravaginal practice.</p>d<p>Based on a subset of 257 women tested for BV at baseline in the Zimbabwe study site only.</p>", "links"=>[], "tags"=>["prevalence", "intravaginal", "practices", "bv", "included", "cohort", "studies"], "article_id"=>469278, "categories"=>["Neuroscience", "Computational Biology", "Medicine"], "users"=>["Nicola Low", "Matthew F. Chersich", "Kurt Schmidlin", "Matthias Egger", "Suzanna C. Francis", "Janneke H. H. M. van de Wijgert", "Richard J. Hayes", "Jared M. Baeten", "Joelle Brown", "Sinead Delany-Moretlwe", "Rupert Kaul", "Nuala McGrath", "Charles Morrison", "Landon Myer", "Marleen Temmerman", "Ariane van der Straten", "Deborah Watson-Jones", "Marcel Zwahlen", "Adriane Martin Hilber"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000416.t002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Baseline_prevalence_of_intravaginal_practices_and_BV_in_included_cohort_studies_n_8202_8202_14_874_/469278", "title"=>"Baseline prevalence of intravaginal practices and BV in included cohort studies (<i>n = </i>14,874).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-02-15 02:34:38"}
  • {"files"=>["https://ndownloader.figshare.com/files/798987"], "description"=>"<p>HRs from two-stage random effects meta-analysis. Intravaginal practices measured at baseline; reference category is no vaginal practice or use of water only.</p>a<p>Numbers of observations differ from <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000416#pmed-1000416-g001\" target=\"_blank\">Figures 1</a>–<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000416#pmed-1000416-g002\" target=\"_blank\"></a><a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000416#pmed-1000416-g003\" target=\"_blank\"></a><a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000416#pmed-1000416-g004\" target=\"_blank\">4</a> because they exclude those with no BV measurement, mostly from study 7 in which BV was measured only in a subset at baseline in the Zimbabwe site; model for insertion of products also excludes study 2, which did not ask about this practice.</p>b<p>Adjusted for age, marital status, and reported number of sex partners in last 3 mo, as recorded at cohort entry.</p>c<p>BV as binary variable defined as Nugent score of 7–10, Ison-Hay grade III, or the presence of three or more Amsel criteria.</p>", "links"=>[], "tags"=>["intravaginal", "practices", "hiv", "adjusting", "measures", "disrupted", "vaginal"], "article_id"=>469336, "categories"=>["Neuroscience", "Computational Biology", "Medicine"], "users"=>["Nicola Low", "Matthew F. Chersich", "Kurt Schmidlin", "Matthias Egger", "Suzanna C. Francis", "Janneke H. H. M. van de Wijgert", "Richard J. Hayes", "Jared M. Baeten", "Joelle Brown", "Sinead Delany-Moretlwe", "Rupert Kaul", "Nuala McGrath", "Charles Morrison", "Landon Myer", "Marleen Temmerman", "Ariane van der Straten", "Deborah Watson-Jones", "Marcel Zwahlen", "Adriane Martin Hilber"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000416.t003"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Associations_between_intravaginal_practices_and_HIV_acquisition_adjusting_for_different_measures_of_disrupted_vaginal_flora_/469336", "title"=>"Associations between intravaginal practices and HIV acquisition, adjusting for different measures of disrupted vaginal flora.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-02-15 02:35:36"}
  • {"files"=>["https://ndownloader.figshare.com/files/799037"], "description"=>"<p>Number of incident HIV infections during up to 2 y follow-up (n = 14,874), ordered geographically from north to south.</p>a<p>From study protocol or publication.</p>b<p>Includes only women who were HIV negative at start of follow-up and had at least one follow-up visit.</p>c<p>Includes women who attended a follow-up visit at 12 mo ±30 d, except study 6, which includes women who completed study follow-up at 9 mo.</p><p>FPC, family planning clinic; SD, standard deviation; STI, sexually transmitted infections.</p>", "links"=>[], "tags"=>["cohort"], "article_id"=>469389, "categories"=>["Neuroscience", "Computational Biology", "Medicine"], "users"=>["Nicola Low", "Matthew F. Chersich", "Kurt Schmidlin", "Matthias Egger", "Suzanna C. Francis", "Janneke H. H. M. van de Wijgert", "Richard J. Hayes", "Jared M. Baeten", "Joelle Brown", "Sinead Delany-Moretlwe", "Rupert Kaul", "Nuala McGrath", "Charles Morrison", "Landon Myer", "Marleen Temmerman", "Ariane van der Straten", "Deborah Watson-Jones", "Marcel Zwahlen", "Adriane Martin Hilber"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000416.t001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_participants_of_individual_cohort_studies_/469389", "title"=>"Characteristics of participants of individual cohort studies.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-02-15 02:36:29"}

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  • {"unique-ip"=>"10", "full-text"=>"10", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
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Relative Metric

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