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The Use of Rectal Douches among HIV-uninfected and Infected Men who Have Unprotected Receptive Anal Intercourse: Implications for Rectal Microbicides

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Abstract

Although some rectal douches result in surface epithelium loss and potential increase of HIV transmission, men who have sex with men (MSM) continue to use them. We describe the prevalence of this practice among MSM engaging in unprotected receptive anal intercourse (URAI) in risky circumstances. A multiethnic sample with overrepresentation of HIV-negative MSM who had URAI in the previous year was recruited exclusively through the Internet. Participants were 105 MSM (78 HIV-negative, 27 HIV-positive). A total of 53% of HIV-negative and 96% of HIV-positive men douched in preparation for sex, most of them frequently or always, mainly for hygienic purposes. 27% of HIV-negative and 44% of HIV-positive douched after sex, partly believing douching protected from infections. Douching practices started around age 25. Regression analyses found the association between HIV status and douching occasions persisted after controlling for demographic characteristics and number of URAI occasions. Rectal douching in preparation for sex is common among men who practice URAI. This population could benefit from alternatives to condoms, such as rectal microbicides. Given the popularity of pre-coital douching and its frequency, a harmless rectal douche that could deliver a rectal microbicide could have great acceptability.

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References

  • Bienzle, U., Guggenmoos-Holzmann, I., Zwingenberger, K., Thommsen, R., Ritter, K., & Uy, A., et al. (1985). Lymphadenopathy and antibodies to HTLV-III in homosexual men Clinical, laboratory and epidemiological features. Journal of Molecular Medicine, 63, 597–602.

    CAS  Google Scholar 

  • Carballo-Diéguez, A., & Bauermeister, J. A. (2004). “Barebacking”: Intentional condomless anal sex in HIV-risk contexts: Reasons for and against it. Journal of Homosexuality, 47, 1–16.

    Article  PubMed  Google Scholar 

  • Carballo-Diéguez, A., Dowsett, G. A., Ventuneac, A., Remien, R. H., Balan, I., Dolezal, C., Luciano, O., & Lin, P. (2006). Cybercartography of popular Internet sites used by New York City men who have sex with men interested in bareback sex. AIDS Education & Prevention, 18(6), 475–489.

    Article  Google Scholar 

  • Carballo-Diéguez, A., Exner, T., Dolezal, C., Pickard, R., Lin, P., & Mayer, K. H. (2007). Rectal microbicide acceptability: Results of a volume escalation trial. Sexually Transmitted Diseases, 34(4), 224–229.

    Article  PubMed  Google Scholar 

  • Carballo-Diéguez, A., Stein, Z., Saez, H., Dolezal, C., Nieves-Rosa, L., & Diaz, F. (1999). Frequent use of lubricants for anal sex among men who have sex with men: the HIV prevention potential of a microbicidal gel. American Journal of Public Health, 90, 1117–1121.

    Article  Google Scholar 

  • Deininger, S., Müller, R., Guggenmoos-Holzmann, I., Laukamm-Josten, U., & Bienzle, U. (1990). Behavioral characteristics and laboratory parameters in homo- and bisexual men in West Berlin: An evaluation of five years of testing and counseling on AIDS. Journal of Molecular Medicine, 68, 906–913.

    CAS  Google Scholar 

  • Fuchs, E. J., Lee, L. A., Torbenson, M. S., Parsons, T. L., Bakshi, R. P., & Guidos, A. M., et al. (2007). Hyperosmolar sexual lubricant causes epithelial damage in the distal colon: Potential implication for HIV transmission. Journal of Infectious Diseases, 195(5), 703–710.

    Article  PubMed  Google Scholar 

  • Hylton, J., Hendrix, C., & Fuchs, E. (2004). An assessment of sexual practices affecting the feasibility of microbicide development among MSM. Oral Poster presented at Microbicides 2004, London.

  • Koblin, B. A., Mayer, K., Mwatha, A., Brown-Peterside, P., Holt, R., & Marmor, M., et al. (2002). Douching practices among women at high risk of HIV infection in the United States: Implications for microbicide testing and use. Sexually Transmitted Diseases, 29, 406–410.

    Article  PubMed  Google Scholar 

  • Koziol, D. E., Saah, A. J., Odaka, N., & Munoz, A. (1993). A comparison of risk factors for human immunodeficiency virus and hepatitis B virus infections in homosexual men. Annals of Epidemiology, 3, 434–441.

    Article  PubMed  CAS  Google Scholar 

  • Martino, J. L., & Vermund, S. H. (2002). Vaginal douching: Evidence for risks or benefits to women’s health. Epidemiologic Reviews, 24, 109–124.

    Article  PubMed  Google Scholar 

  • Moss, A. R., Osmond, D., Bacchetti, P., Chermann, J. C., Barre-Sinoussi, F., & Carlson, J. (1987). Risk factors for AIDS and HIV seropositivity in homosexual men. American Journal of Epidemiology, 125, 1035–1047.

    PubMed  CAS  Google Scholar 

  • Ndimbie, O. K., Kingsley, L. A., Nedjar, S., & Rinaldo, C. R. (1996). Hepatitis C virus infection in male homosexual cohort: Risk factor analysis. Genitourinary Medicine, 72, 213–216.

    PubMed  CAS  Google Scholar 

  • Ness, R. B., Hillier, S. L., Richter, H. E., Soper, D. E., Stamm, C., & Bass, D. C., et al. (2003). Why women douche and why they may or may not stop. Sexually Transmitted Diseases, 30, 71–74.

    Article  PubMed  Google Scholar 

  • Phillips, D., Taylor, C., Zacharopoulos, V., & Maguire, R. (2000). Nonoxynol-9 causes rapid exfoliation of sheets of rectal epithelium. Contraception, 62, 149–154.

    Article  PubMed  CAS  Google Scholar 

  • Prentice, R. L., & Pyke, R. (1979). Logistic disease incidence models and case-control studies. Boimetrika, 66(3), 403–411.

    Article  Google Scholar 

  • Schmelzer, M., Schiller, L. R., Meyer, R., Rugari, S. M., & Case, P. (2004). Safety and effectiveness of large-volume enema solutions. Applied Nursing Research, 17, 265–274.

    Article  PubMed  Google Scholar 

  • Schreeder, M. T., Thompson, S. E., Hadler, S. C., Berquist, K. R., Zaidi, A., & Maynard, J. E., et al. (1982). Hepatitis B in homosexual men: Prevalence of infection and factors related to transmission. Journal of Infectious Diseases, 146, 7–15.

    PubMed  CAS  Google Scholar 

  • Suarez, T., & Miller, J. (2001). Negotiating risks in context: A perspective on unprotected anal intercourse and barebacking among men who have sex with men—Where do we go from here? Archives of Sexual Behavior, 30, 287–300.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Alex Carballo-Diéguez.

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Carballo-Diéguez, A., Bauermeister, J.A., Ventuneac, A. et al. The Use of Rectal Douches among HIV-uninfected and Infected Men who Have Unprotected Receptive Anal Intercourse: Implications for Rectal Microbicides. AIDS Behav 12, 860–866 (2008). https://doi.org/10.1007/s10461-007-9301-0

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