Penile hygiene-Everything you didn’t know about the hygiene practices of fishermen in Kisumu, Kenya

Genital hygiene practices of fishermen targeted for a topical microbicide intervention against sexually transmitted infections in Kisumu, Kenya
Kwena ZA, Bukusi EA, Gorbach P, Sharma A, Sang NM, Holmes KK. Int J STD AIDS. 2010;21:435-40.

Research on hygiene has been relatively limited in the current era of rigorous observational studies and clinical trials. Kwena and colleagues set out to investigate the perception and practices of genital hygiene among fishermen working on the beaches along Lake Victoria, targeted for a topical male microbicide hygiene intervention. They conducted 12 focus group discussions involving fishermen (n = 130), recording the discussions in Dholuo (the local language) and transcribing them verbatim before translating into English. Transcripts were double-coded and analysed using constant comparative analysis. Despite easy access to lake water and recognition of a link that may exist between poor genital hygiene and the risk of penile infection and poor sexual relationships, few fishermen regularly washed their genitalia due to fear/embarrassment from cleaning their genitalia in public, traditional Luo beliefs such as that washing with soap would reduce the fish catch, lack of time because of their busy schedules, laziness and lack of responsibility, and excessive consumption of alcohol and illicit drugs. Hygiene practices of the fishermen were poor and could contribute to genital infections including sexually transmitted infections. Given the fishermen's poor genital hygiene practices, they may benefit from hygiene intervention, including that provided by penile microbicides, which can be applied in the privacy of their bedrooms.

For abstract click here: http://www.ncbi.nlm.nih.gov/pubmed/20606226

Editors’ note: This qualitative study among primarily Luo fishermen at 32 beaches along Lake Victoria is an example of ‘formative research’. A variety of methodologies can be used in formative research to better understand the behaviours, attitudes, and practices of a population in which a trial is to be conducted. Formative research can also help discover how best to reach priority populations at the stage of programme design. The focus here is on understanding the poor hygiene practices of uncircumcised fishermen in preparation for a topical penile wipe intervention. One of the more striking beliefs that emerged in the focus groups was that the vagina cleans the penis. Another finding was that women are less likely to comment about a man’s poor hygiene if it is a transactional sexual relationship, such as when a woman receives free fish or fish at a reduced price. The idea of a penile wipe is not new – military forces with limited access to water in combat zones in both World War I and II used a penile microbicide to reduce the risk of sexually transmitted infections. Despite the fact that the water of Lake Victoria is all around, lack of privacy may be the most important reason that the penile wipe concept would be attractive to uncircumcised men.