{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T06:58:32Z","timestamp":1773298712476,"version":"3.50.1"},"reference-count":47,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["ajog.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Obstetrics and Gynecology"],"published-print":{"date-parts":[[2009,1]]},"DOI":"10.1016\/j.ajog.2008.06.026","type":"journal-article","created":{"date-parts":[[2008,7,31]],"date-time":"2008-07-31T08:56:32Z","timestamp":1217494592000},"page":"38.e1-38.e8","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":25,"title":["Does douching increase risk for sexually transmitted infections? A prospective study in high-risk adolescents"],"prefix":"10.1016","volume":"200","author":[{"given":"Cynthia S.","family":"Tsai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan E.","family":"Shepherd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sten H.","family":"Vermund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.ajog.2008.06.026_bib1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1089\/152460902753473435","article-title":"Douching beliefs and practices among black and white women","volume":"11","author":"Funkhouser","year":"2002","journal-title":"J Womens Health Gend Based Med"},{"key":"10.1016\/j.ajog.2008.06.026_bib2","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1089\/jwh.2004.13.1048","article-title":"Vaginal douching: personal practices and public policies","volume":"13","author":"Martino","year":"2004","journal-title":"J Womens Health"},{"key":"10.1016\/j.ajog.2008.06.026_bib3","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1093\/epirev\/mxf004","article-title":"Vaginal douching: evidence for risks or benefits to women's health","volume":"24","author":"Martino","year":"2002","journal-title":"Epidemiol Rev"},{"key":"10.1016\/j.ajog.2008.06.026_bib4","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1097\/00007435-200301000-00014","article-title":"Why women douche and why they may or may not stop","volume":"30","author":"Ness","year":"2003","journal-title":"Sex Transm Dis"},{"key":"10.1016\/j.ajog.2008.06.026_bib5","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1111\/j.1552-6909.2006.00003.x","article-title":"Vaginal douching practices of women in eight Florida Panhandle counties","volume":"35","author":"Cottrell","year":"2006","journal-title":"J Obstet Gynecol Neonatal Nurs"},{"key":"10.1016\/j.ajog.2008.06.026_bib6","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1097\/00007435-200104000-00010","article-title":"Douching and endometritis: results from the PID evaluation and clinical health (PEACH) study","volume":"28","author":"Ness","year":"2001","journal-title":"Sex Transm Dis"},{"key":"10.1016\/j.ajog.2008.06.026_bib7","doi-asserted-by":"crossref","first-page":"1936","DOI":"10.1001\/jama.1990.03440140062032","article-title":"Association between vaginal douching and acute pelvic inflammatory disease","volume":"263;","author":"Wolner-Hanssen","year":"1990","journal-title":"JAMA"},{"key":"10.1016\/j.ajog.2008.06.026_bib8","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1097\/00007435-199808000-00010","article-title":"Social and behavioral correlates of pelvic inflammatory disease","volume":"25","author":"Aral","year":"1998","journal-title":"Sex Transm Dis"},{"key":"10.1016\/j.ajog.2008.06.026_bib9","doi-asserted-by":"crossref","first-page":"844","DOI":"10.2105\/AJPH.86.6.844","article-title":"Vaginal douching and reduced fertility","volume":"86","author":"Baird","year":"1996","journal-title":"Am J Public Health"},{"key":"10.1016\/j.ajog.2008.06.026_bib10","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/S0002-9378(97)70391-0","article-title":"Vaginal douching as a risk factor of ectopic pregnancy among black women","volume":"176","author":"Kendrick","year":"1997","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajog.2008.06.026_bib11","first-page":"913","article-title":"The risk of low birth weight associated with vaginal douching","volume":"92","author":"Fiscella","year":"1998","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajog.2008.06.026_bib12","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1054\/mehy.1999.0875","article-title":"Vaginal douching and preterm birth: an intriguing hypothesis","volume":"54","author":"Bruce","year":"2000","journal-title":"Med Hypotheses"},{"key":"10.1016\/j.ajog.2008.06.026_bib13","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1067\/mob.2002.122406","article-title":"Risk of preterm birth that is associated with vaginal douching","volume":"186","author":"Fiscella","year":"2002","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajog.2008.06.026_bib14","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1093\/oxfordjournals.aje.a115890","article-title":"Is vaginal douching related to cervical carcinoma?","volume":"133","author":"Gardner","year":"1991","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.ajog.2008.06.026_bib15","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1097\/01.olq.0000205046.11916.c5","article-title":"Vaginal douche practices among black women at risk: exploring douching prevalence, reasons for douching, and sexually transmitted disease infection","volume":"33","author":"Annang","year":"2006","journal-title":"Sex Transm Dis"},{"key":"10.1016\/j.ajog.2008.06.026_bib16","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1136\/sti.77.4.271","article-title":"Sexually transmitted infections and vaginal douching in a population of female sex workers in Nairobi, Kenya","volume":"77","author":"Fonck","year":"2001","journal-title":"Sex Transm Infect"},{"key":"10.1016\/j.ajog.2008.06.026_bib17","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.2105\/AJPH.91.10.1664","article-title":"Factors linked to bacterial vaginosis in nonpregnant women","volume":"91","author":"Holzman","year":"2001","journal-title":"Am J Public Health"},{"key":"10.1016\/j.ajog.2008.06.026_bib18","first-page":"993","article-title":"Vaginal douching as a risk factor for cervical Chlamydia trachomatis infection","volume":"91","author":"Scholes","year":"1998","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajog.2008.06.026_bib19","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/S1083-3188(03)00027-5","article-title":"Douching behaviors reported by adolescent and young adult women at high risk for sexually transmitted infections","volume":"16","author":"Blythe","year":"2003","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"10.1016\/j.ajog.2008.06.026_bib20","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/S0002-9378(96)70382-4","article-title":"Douching and sexually transmitted diseases in pregnant women in Surabaya, Indonesia","volume":"174","author":"Joesoef","year":"1996","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajog.2008.06.026_bib21","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1097\/01.OLQ.0000114942.41998.58","article-title":"Intravaginal practices, HIV and other sexually transmitted diseases among South African women","volume":"31","author":"Myer","year":"2004","journal-title":"Sex Transm Dis"},{"key":"10.1016\/j.ajog.2008.06.026_bib22","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/S0932-8610(12)80023-5","article-title":"The relationship between vaginal douching and lower genital tract infection in young women","volume":"5","author":"Chacko","year":"1992","journal-title":"Adolesc Pediatr Gynecol"},{"key":"10.1016\/j.ajog.2008.06.026_bib23","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/S1054-139X(97)00209-7","article-title":"Detection of Chlamydia trachomatis cervical infection by urine tests among adolescents","volume":"22;","author":"Beck-Sague","year":"1998","journal-title":"J Adolesc Health"},{"key":"10.1016\/j.ajog.2008.06.026_bib24","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1093\/oxfordjournals.aje.a116840","article-title":"Selective screening for Chlamydia trachomatis infection in a primary care population of women","volume":"138","author":"Stergachis","year":"1993","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.ajog.2008.06.026_bib25","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1097\/00007435-199904000-00001","article-title":"Vaginal douching: association with lower genital tract infections in African pregnant women","volume":"26","author":"La Ruche","year":"1999","journal-title":"Sex Transm Dis"},{"key":"10.1016\/j.ajog.2008.06.026_bib26","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1177\/000992280003900307","article-title":"Behaviors associated with Neisseria gonorrhoeae and Chlamydia trachomatis: Cervical infection among young women attending adolescent clinics","volume":"39","author":"Peters","year":"2000","journal-title":"Clin Pediatr (Phila)"},{"key":"10.1016\/j.ajog.2008.06.026_bib27","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1093\/aje\/kwi025","article-title":"Douching, pelvic inflammatory disease, and incident gonococcal and chlamydial genital infection in a cohort of high-risk women","volume":"161","author":"Ness","year":"2005","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.ajog.2008.06.026_bib28","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1093\/infdis\/174.5.1058","article-title":"Hydrogen peroxide-producing lactobacilli and acquisition of vaginal infections","volume":"174","author":"Hawes","year":"1996","journal-title":"J Infect Dis"},{"key":"10.1016\/j.ajog.2008.06.026_bib29","first-page":"333","article-title":"Quantitative and qualitative effects of douche preparations on vaginal microflora","volume":"80","author":"Onderdonk","year":"1992","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajog.2008.06.026_bib30","first-page":"765","article-title":"Douching in relation to bacterial vaginosis, lactobacilli, and facultative bacteria in the vagina","volume":"100","author":"Ness","year":"2002","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajog.2008.06.026_bib31","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1016\/0002-9378(92)91368-K","article-title":"Characteristics of three vaginal flora patterns assessed by gram stain among pregnant women","volume":"166","author":"Hillier","year":"1992","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ajog.2008.06.026_bib32","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1097\/00006250-199203000-00008","article-title":"The relationship of hydrogen peroxide-producing lactobacilli to bacterial vaginosis and genital microflora in pregnant women","volume":"79","author":"Hillier","year":"1992","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajog.2008.06.026_bib33","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/S0140-6736(97)01063-5","article-title":"HIV-1 infection associated with abnormal vaginal flora morphology and bacterial vaginosis","volume":"350","author":"Sewankambo","year":"1997","journal-title":"Lancet"},{"key":"10.1016\/j.ajog.2008.06.026_bib34","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1097\/00006250-199910000-00027","article-title":"The great douching debate: to douche, or not to douche","volume":"94","author":"Monif","year":"1999","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ajog.2008.06.026_bib35","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1093\/aje\/kwj071","article-title":"Distinguishing the temporal association between women's intravaginal practices and risk of human immunodeficiency virus infection: a prospective study of South African women","volume":"163","author":"Myer","year":"2006","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.ajog.2008.06.026_bib36","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1097\/01.aids.0000196165.48518.7b","article-title":"Vaginal washing and increased risk of HIV-1 acquisition among African women: a 10-year prospective study","volume":"20","author":"McClelland","year":"2006","journal-title":"AIDS"},{"key":"10.1016\/j.ajog.2008.06.026_bib37","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/S1054-139X(01)00291-9","article-title":"The REACH (Reaching for Excellence in Adolescent Care and Health) Project: study design, methods, and population profile","volume":"29","author":"Wilson","year":"2001","journal-title":"J Adolesc Health"},{"key":"10.1016\/j.ajog.2008.06.026_bib38","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/S1054-139X(97)00279-6","article-title":"The REACH Project of the Adolescent Medicine HIV\/AIDS Research Network: design, methods and selected characteristics of participants","volume":"22","author":"Rogers","year":"1998","journal-title":"J Adolesc Health"},{"key":"10.1016\/j.ajog.2008.06.026_bib39","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/S1054-139X(01)00284-1","article-title":": Douching practices among HIV-infected and uninfected adolescents in the United States","volume":"295","author":"Vermund","year":"2001","journal-title":"J Adolesc Health"},{"issue":"3 Suppl","key":"10.1016\/j.ajog.2008.06.026_bib40","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/S1054-139X(01)00296-8","article-title":"Sexually transmitted infections among HIV infected and HIV uninfected high-risk youth in the REACH study: reaching for Excellence in Adolescent Care and Health","volume":"29","author":"Vermund","year":"2001","journal-title":"J Adolesc Health"},{"issue":"Suppl","key":"10.1016\/j.ajog.2008.06.026_bib41","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/S1054-139X(01)00283-X","article-title":"Correlation between urine and cervical specimens for the detection of cervical Chlamydia trachomatis and Neisseria gonorrhoeae using ligase chain reaction in a cohort of HIV infected and uninfected adolescents","volume":"29","author":"Peralta","year":"2001","journal-title":"J Adolesc Health"},{"key":"10.1016\/j.ajog.2008.06.026_bib42","doi-asserted-by":"crossref","first-page":"121","DOI":"10.2307\/2531248","article-title":"Longitudinal data analysis for discrete and continuous outcomes","volume":"42","author":"Zeger","year":"1986","journal-title":"Biometrics"},{"key":"10.1016\/j.ajog.2008.06.026_bib43","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1128\/jcm.29.2.297-301.1991","article-title":"Reliability of diagnosing bacterial vaginosis by a standardized method of Gram stain interpretation","volume":"29","author":"Nugent","year":"1991","journal-title":"J Clin Microbiol"},{"issue":"Suppl 3","key":"10.1016\/j.ajog.2008.06.026_bib44","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/S1054-139X(01)00287-7","article-title":"No change in health risk behaviors over time among HIV-infected adolescents in care: role of psychological distress","volume":"29","author":"Murphy","year":"2001","journal-title":"J Adolesc Health"},{"key":"10.1016\/j.ajog.2008.06.026_bib45","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1086\/427262","article-title":"Contribution of HIV-1 infection to acquisition of sexually transmitted disease: a 10-year prospective study","volume":"191","author":"McClelland","year":"2005","journal-title":"J Infect Dis"},{"key":"10.1016\/j.ajog.2008.06.026_bib46","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1097\/01.olq.0000190018.58079.05","article-title":"An intervention to reduce vaginal douching among adolescent and young adult women: a randomized, controlled trial","volume":"32","author":"Grimley","year":"2005","journal-title":"Sex Transm Dis"},{"key":"10.1016\/j.ajog.2008.06.026_bib47","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1046\/j.1525-1446.2000.00053.x","article-title":"Prevention strategies other than male condoms employed by low-income women to prevent HIV infection","volume":"17","author":"Crosby","year":"2000","journal-title":"Public Health Nurs"}],"container-title":["American Journal of Obstetrics and Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002937808006364?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002937808006364?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T10:30:08Z","timestamp":1757586608000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002937808006364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,1]]},"references-count":47,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2009,1]]}},"alternative-id":["S0002937808006364"],"URL":"https:\/\/doi.org\/10.1016\/j.ajog.2008.06.026","relation":{},"ISSN":["0002-9378"],"issn-type":[{"value":"0002-9378","type":"print"}],"subject":[],"published":{"date-parts":[[2009,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Does douching increase risk for sexually transmitted infections? A prospective study in high-risk adolescents","name":"articletitle","label":"Article Title"},{"value":"American Journal of Obstetrics and Gynecology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ajog.2008.06.026","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"https:\/\/doi.org\/10.1016\/j.ajog.2008.11.011","name":"associatedlink","label":"CrossRef DOI link to the associated document"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2009 Mosby, Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}