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Rectal Douching Prevalence and Practices Among Peruvian Men Who have Sex with Men and Transwomen: Implications for Rectal Microbicides

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Abstract

Peruvian men who have sex with men (MSM) and transwomen (TW) could benefit from a rectal microbicide (RM) formulated as a rectal douche to prevent HIV infection. However, little is known about rectal douching practices among Peruvian MSM and TW, information necessary to inform RM douche development and future uptake. Using a self-administered interview, we examined the prevalence of and factors associated with rectal douching among a convenience sample of 415 Peruvian MSM and 68 TW. In the previous 6 months, 18 % of participants reported rectal douching using pre-filled commercial kits or plastic bottles or enema bags filled with water, water/soap or saltwater. Multivariate logistic analysis found that “equally insertive and receptive” or “exclusively/mainly receptive” sex roles were associated with douche use. Rectal douching among Peruvian MSM and TW is similar to reports from other studies and supports the potential uptake of a douche-formulated RM in these populations.

Resumen

Los hombres que tienen sexo con otros hombres (HSH) y las mujeres transgénero (MT) peruanos podrían beneficiarse con microbicidas rectales (MR) formulados como una ducha rectal para prevenir la infección por VIH. Sin embargo, se conoce poco sobre las prácticas de duchas rectales entre HSH y MT en Perú, información necesaria para orientar el desarrollo de MR y su futura aceptación. Utilizando una entrevista auto-administrada, examinamos la prevalencia y los factores asociados con el uso de duchas rectales en una muestra por conveniencia de 415 HSH y 68 MT peruanos. En los seis meses recientes, 18% de los participantes reportaron haber usado duchas rectales comerciales pre-llenados o botellas de plástico o bolsas para enema llenas con agua, agua con jabón, o agua salada. El análisis multivariado encontró que los roles sexuales "igualmente insertivos o receptivos" o "exclusivamente/principalmente receptivos" estaban asociados con el uso de duchas rectales. El uso de duchas rectales entre HSH y MT es similar a lo reportado en otros estudios y da respaldo a la posible aceptación por parte de estas poblaciones de los MR formulados.

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Acknowledgments

We are grateful to the men and women who participated in this study as well as the staff at the community center Epicentro in Lima, Peru where the study was conducted. This work was supported in part by a research grant from the Merck Investigator-Initiated Studies Program of Merck & Co., Inc., NIH grant T32 MH080634 and the NIH Health Disparities Research Loan Repayment Program. The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck & Co., Inc. We also thank the International Rectal Microbicides Advocates (IRMA) who provided access to the global rectal douching survey and allowed its modification for use in the present study.

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Authors and Affiliations

  1. Socios En Salud, Lima, Peru

    Jerome T. Galea & Segundo R. Leon

  2. Epicentro Salud, Lima, Peru

    Jerome T. Galea, Gino Calvo & Hugo Sánchez

  3. Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, CA, USA

    Janni J. Kinsler

  4. The Fenway Institute, Fenway Health, Boston, MA, USA

    Sarah McLean

  5. Laboratory of Sexual Health, Universidad Peruana Cayetano Heredia School of Public Health, Lima, Peru

    Segundo R. Leon

  6. Center for Healthy Communities, School of Medicine, University of California, Riverside, CA, USA

    Brandon Brown

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  1. Jerome T. Galea
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  2. Janni J. Kinsler
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  3. Sarah McLean
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  4. Gino Calvo
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  5. Hugo Sánchez
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  6. Segundo R. Leon
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  7. Brandon Brown
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Correspondence to Jerome T. Galea.

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Galea, J.T., Kinsler, J.J., McLean, S. et al. Rectal Douching Prevalence and Practices Among Peruvian Men Who have Sex with Men and Transwomen: Implications for Rectal Microbicides. AIDS Behav 20, 2555–2564 (2016). https://doi.org/10.1007/s10461-015-1221-9

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