title: The use of rectal douches among HIV-uninfected and infected men who have unprotected receptive anal intercourse: implications for rectal microbicides.
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.
authors: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Unit 15, 1051 Riverside Drive, New York, NY 10032, USA. ac72@columbia.edu
authors: Alex
authors: A
authors: Carballo-Diéguez
authors: José A
authors: JA
authors: Bauermeister
authors: Ana
authors: A
authors: Ventuneac
authors: Curtis
authors: C
authors: Dolezal
authors: Ivan
authors: I
authors: Balan
authors: Robert H
authors: RH
authors: Remien
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D018451:Homosexuality, Male; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D012007:Rectum; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D007507:Therapeutic Irrigation / Q000706:statistics & numerical data*; D047568:Unsafe Sex / Q000706:statistics & numerical data*
chemical_list: D000890:Anti-Infective Agents
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