Contraception Education: Downloads

Dry Sex
This information has been compiled by Barbara Hastings-Asatourian to stimulate debate about the harmful potential from practices such as “dry sex”. It provides another opportunity to promote safe condom use, and to point out which chemical substances damage latex condoms.

Teachers and facilitators may wish to use the following reading literature to supplement the discussion which arises or they may wish to use it as additional reading for a group of learners.

A comprehensive bibliography about dry sex is available at www.rho.org under “Harmful Practices”, some of which has been included at the end of this compilation.

Dry sex refers to a range of practices including wiping, inserting herbal and other preparations into a woman’s vagina to cleanse, dry, or tighten it. A variety of practices is reported in 11 sub-Saharan countries and practices and also vary among individual women, ethnic groups, and different communities. In one survey in Kwazulu Natal 80% of the women questioned said they practice dry sex. (Baleta 1998)
Reasons for practising dry sex:
• Dry sex is practised in the belief that it will remove vaginal secretions, tighten and "warm" the vagina
• Vaginal secretions and wetness are often culturally associated with unfaithfulness, lack of cleanliness and infection.
• Dry sex is practised to provide sexual satisfaction for the husband/partner in order to ensure his fidelity.
• It is often believed that dry sex promotes cleanliness, fertility, and good health.
• By douching or using dry sex agents, women believe they are also strengthening the body, preventing reproductive disease, and toning pelvic muscles.
• To enhance male sexual arousal.
• Some agents may be used to specifically prevent and treat sexually transmitted diseases and vaginal infections, itching, and discharge.
However there is widespread concern and research evidence that drying practices increase transmission of HIV and other STIs by
• drying out and irritating vaginal mucosa
• disturbing normal vaginal bacteria
• interfering with condom safety and use.

Additional reading

Baleta, A. Concern voiced over "dry sex" practices in South Africa. Lancet 352(9136): 1292 (October 17, 1998).
This short overview of dry sex practices in southern Africa notes that women primarily use substances to cause their vaginas to be "hot, tight and dry." The practice is worrisome given the high rates of HIV in South Africa in particular—the Deputy President estimates 1,500 South Africans are infected each day. Within South Africa, the practice of dry sex seems to be most prevalent in Kwazulu Natal, which has the highest rate of HIV/AIDS. Research has found that 80 percent of sex workers in this region practice dry sex; most sex workers practice dry sex in order to avoid reminding clients that they recently have had sex with other men. Researchers urge public health interventions that address the practice and accompanying issues, especially the interference in condom use.
Available online at http://www.cirp.org/library/disease/HIV/baleta1
Beksinska ME, Rees HV, Kleinschmidt I, McIntyre J. The practice and prevalence of dry sex among men and women in South Africa: a risk factor for sexually transmitted infections? Sex Transm Infect 1999;75(3):178-80.
Available online at http://www.cirp.org/library/disease/HIV/beksinska1
Kun, K. Vaginal drying agents and HIV transmission. International Family Planning Perspectives 24(2):93–94 (June 1998). Available online at http://www.agi-usa.org/pubs/journals/2409398.html.
Kun provides a basic overview of vaginal drying agents, their use, research findings on HIV transmission, and programming implication. The author notes the complex nature of vaginal drying agent practices and the need for more qualitative data on the topic. The author reports on an evaluation of sex workers in Zaire, who were examined before and after inserting drying agents. Of the seven participants, only one was left with intact vagina mucosa. All others had vaginal inflammation resembling a chemical burn or allergic reaction.
Available online at http://www.agi-usa.org/pubs/journals/2409398.html
McGrory E. and Gupta, G. 2002. Preparing for Microbicides Access and Use. New York: Rockefeller Foundation
PATH (Program for Appropriate Technology in Health). Vaginal douching: unnecessary and potentially harmful? Outlook 15(4):6–7 (December 1997). A short outline of dry sex practices is presented, including a description of the practice, items used, and reasons. The high incidence of STIs and HIV/AIDS in regions where the practice is common is noted with concern. The physiological reasons for concern include vaginal inflammation, abrasion, and peeling skin, all of which may increase transmission. Health providers are urged to discuss the practice with clients. A detailed article on risks associated with douching accompanies it.

Ray, S. et al. Local voices: what some Harare men say about preparation for sex. Reproductive Health Matters 7:34–45 (May 1996). Available on line at www.rhmjournal.org.uk/PDFs/07ray.pdf.
“For more effective prevention strategies against heterosexual transmission of HIV to be developed in Africa, it is essential to look at lay beliefs and attitudes towards sex, as well as negotiation strategies and gender relations between sexual partners. Any reduction in practices which enhance women’s vulnerability will require the willingness of men. The study described here was a pilot study among male factory workers in Harare, to examine their perceptions of techniques used in preparation for sex by men and women. The men described the use of herbs and aphrodisiacs by men to enhance sexual performance, and the use of drying agents by women for vaginal cleansing purposes and for enhancement of sexual pleasure for male partners. Within the context of high HIV prevalence in the country, this paper recommends strategies of peer education and involving health workers and families to address sexual beliefs and behaviour, to encourage safer sex practices”
This article provides extensive qualitative information about Harare men´s knowledge, attitudes, and practices concerning both male and female preparation for sex, and men´s feelings about dry sex practices. Seventeen male factory workers provided detail about the use of herbs and aphrodisiacs in preparation for sex. Generally they see sexual lust as a natural, essential desire, and they view herbs as necessary to strengthening themselves for intercourse. The men use ground herbs mixed with food or drink, or products that are applied directly to the genitals. Men prefer a woman´s vagina to be dry (perceiving it to be cleaner and healthier) and tight. Women dry and tighten their vaginas using cloth, cold water, soap, wool, or herbs taken by mouth, inserted into the vagina, or tied around the waist. Such practices can result in pain during sex for both men and women. Condoms are seen to have both positive and negative potential. These practices, as well as lines of communication about them between and among men and women must be considered within any reproductive health interventions.
Runganga, A.O. and Kasule, J. The vaginal use of herbs/substances: an HIV transmission facilitatory factor? AIDS Care 7(5):639–645 (1995).
This behavioural-analytic study looked at the use of dry sex agents in 75 HIV-positive and 76 HIV-negative women. Ninety-nine percent of the subject used some dry sex agents. Patterns of use among the two groups were similar, except 14 HIV-positive and only 7 HIV-negative subjects had used dry sex herbs known as "Wankie." Problems with potential condom use is discussed.
van de Wijgert, J.H.H.M. et al. Intravaginal practices, vaginal flora disturbances, and acquisition of sexually transmitted diseases in Zimbabwean women. Journal of Infectious Diseases 181:587–94 (2000).
The authors examine possible links between intravaginal practices and disturbances of vaginal flora and acquisition of sexually transmitted infections (STIs). Efforts to find non-users were a challenge, given the apparent widespread use of such practices, which include cleaning the vagina with fingers, wiping the vagina and inserting traditional materials. The research found that users of intravaginal practices were more likely than non-users to have disturbances of the vaginal flora, yet they were not more likely to acquire an STI. Some vaginal flora disturbances and the absence of lactobacilli, however, were associated with increased STI incidence, HIV prevalence, and association with positive HIV status at baseline.
van de Wijgert, J. et al. Men´s attitudes toward vaginal microbicides and microbicide trials in Zimbabwe. Family Planning Perspectives 25(1): 115–120. (March 1999). Available at: www.guttmacher.org/pubs/journals/2501599.html.
Microbicides present an excellent possibility for the many women in Zimbabwe who can´t negotiate condom use and are at risk for HIV and STIs. This article examines men´s views on the topic and finds that their desire for dry sex, as well as their issues about control and fidelity, might present considerable obstacles to women´s microbicide use. For example, the authors found that men would only let their wives participate in the microbicide study if the men were personally approached by the researchers, not just by their wives. (See full article on http://www.guttmacher.org/pubs/journals/2501599.html)

As with all group discussion it is necessary to build in to any session a period of de-briefing, especially when deep rooted beliefs have been challenged and heated debate has been part of the session. The debrief should include a reminder to the group about the ground rules for confidentiality and respect.

Finalist in British Female Inventor of the Year April 2003

Finalist in National Business Awards Entrepreneur Category 2003

A BFIY's Top 10 Woman Inventor and Innovator 2005

Finalist in 2005 E-Commerce ICT Innovators Awards- Health Category (DTI Interforum)

Winner of 2006 Exceptional Exporter Award (UKTI, Chamberlink, Salford City Council)

RESOURCES:Dry Sex and the Risk of HIV Transmission