'Everyone Wants a Vagina That Looks Less Like a Vagina': Australian Women's Views on Dissatisfaction with Genital Appearance

We present a thematic discourse analysis of 94 Australian women's written comments about women's presumed dissatisfaction with their genital appearance. 

Two themes emerged: 'from natural to normal' and 'the difficulty of resistance'. In the first theme, participants discuss genital dissatisfaction with reference to hegemonic constructions of femininity and to postfeminist, neoliberal discourses that position the natural female body as inadequate, with beauty practices necessary to achieve acceptability. 

The second theme addresses the difficulty of challenging this positioning, referencing discourses that position the vagina as unpleasant and discussion of it as taboo. 

We consider implications of these constructions for women's well-being.

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By:   Moran C1, Lee C2.

• 1The University of Queensland, Australia.
• 2The University of Queensland, Australia c.lee@psy.uq.edu.au.
• J Health Psychol. 2016 Mar 23. pii: 1359105316637588. 

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Vaginal Self-Sampling for Human Papillomavirus Infection as a Primary Cervical Cancer Screening Tool in a Haitian Population

Human papillomavirus (HPV) testing as primary cervical cancer screening has not been studied in Caribbean women. We tested vaginal self-collection versus physician cervical sampling in a population of Haitian women.

Participants were screened for high-risk HPV with self-performed vaginal and clinician-collected cervical samples using Hybrid Capture 2 assays (Qiagen, Gaithersburg, MD). Women positive by either method then underwent colposcopy with biopsy of all visible lesions. Sensitivity and positive predictive value were calculated for each sample method compared with biopsy results, with κ statistics performed for agreement. McNemar tests were performed for differences in sensitivity at ≥cervical intraepithelial neoplasia (CIN)-I and ≥CIN-II.

Of 1845 women screened, 446 (24.3%) were HPV positive by either method, including 105 (5.7%) only by vaginal swab and 53 (2.9%) only by cervical swab. Vaginal and cervical samples were 91.4% concordant. Overall, 133 HPV-positive women (29.9%) had CIN-I, whereas 32 (7.2%) had ≥CIN-II. The sensitivity of vaginal swabs was similar to cervical swabs for detecting ≥CIN-I (89.1% vs. 87.9%, respectively) lesions and ≥CIN-II disease (87.5% vs. 96.9%). Eighteen of 19 cases of CIN-III and invasive cancer were found by both methods.

Human papillomavirus screening via self-collected vaginal swabs or physician-collected cervical swabs are feasible options in this Haitian population. The agreement between cervical and vaginal samples was high, suggesting that vaginal sample-only algorithms for screening could be effective for improving screening rates in this underscreened population.

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By:  Boggan JC1, Walmer DK, Henderson G, Chakhtoura N, McCarthy SH, Beauvais HJ, Smith JS.

• 1From the *Duke Global Health Institute, Duke University, Durham, NC; †Department of Medicine, Duke University Health System, Durham, NC; ‡Family Health Ministries, Durham, NC; §PathForceDx, Seattle, WA; ¶University of Miami Health System, Miami, FL; ∥University of Notre Dame-Haiti School of Medicine, Port-au-Prince, Haiti; and **Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC. 

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