In the current study, researchers from Kenya and the United States examined knowledge and behaviors related to hygiene, genital hygiene, circumcision and genital hygiene before and after sex among men in Nairobi. Attitudes and practices regarding genital hygiene may influence males' use of a topical microbicide.

The researchers conducted 463 interviews with men recruited by respondent-driven sampling techniques; in addition, they conducted 10 focus groups with a subsample of 100 volunteers from the larger group. The men responded to individual quantitative survey and qualitative group discussion questions about genital hygiene behaviors and the temporal relation of these behaviors to sexual encounters.

Once-daily bathing was associated with education, income and inside tap water. Genital washing other than regular bathing, and washing before sex, were negatively associated with bathroom crowding. Genital hygiene before most recent sexual encounter was uncommon; it was negatively associated with HIV risk perception, bathroom crowding and ethnicity. Genital washing before sex, the men believed, would arouse suspicions of infidelity or "cool sexual ardour." Post-sex genital washing was associated with education, religion and access to inside tap water. Age, income and having at least one child were associated with genital hygiene after most recent sexual encounter.

"Genital hygiene behaviours were associated with resource access factors and group discussions suggest that they are modulated by interactions in sexual partnerships," the researchers concluded. "Topical microbicides may improve hygiene before and after sex."

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