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AIDS and Behavior

, Volume 22, Issue 4, pp 1288–1294 | Cite as

Rectal Douching Associated with Receptive Anal Intercourse: A Literature Review

  • Alex Carballo-Diéguez
  • Cody Lentz
  • Rebecca Giguere
  • Edward J. Fuchs
  • Craig W. Hendrix
Substantive Review

Abstract

To inform the development of HIV-prevention rectal douches, we reviewed the scientific literature and online instructional videos on rectal douching associated with receptive anal intercourse (RAI). Up to 88% of men who practice RAI ever have douched, while 43–64% have douched recently. Of them, 87–97% douche before RAI and 13–48% afterwards. Water, occasionally mixed with soap or salt, is used most often, although up to 31% of men use commercial products. Douching is more common among individuals reporting substance use, sexually transmitted infections, or being HIV-infected. Scant literature is available on women’s rectal douching practices, but it is apparently less frequent than among men (32 vs. 70%). Videos advise using 2–3 doses of liquid and retaining it for 10–30 s before expelling. These findings can inform the development of a safe and acceptable rectal douche for HIV prevention.

Keywords

Rectal douche HIV prevention Men who have sex with men Microbicides Enema 

Resumen

Para contribuir al proceso de desarrollo de duchas rectales para la prevención del VIH, revisamos la literatura científica y los videos de enseñanza disponibles en el Web sobre el uso de duchas rectales en asociación con el sexo anal receptivo (SAR). Hasta el 88% de los hombres que practican SAR se han administrado alguna vez una ducha rectal, mientras que el 43-64% lo han hecho recientemente. De ellos, 87-97% se administran la ducha antes del SAR y 13-48% después. Agua, a veces mezclada con jabón o sal, es lo que se usa con mayor frecuencia, aunque hasta un 31% de los hombres usan productos comerciales. El uso de duchas rectales es más común entre los individuos que reportan el uso de sustancias, haber tenido infecciones de transmisión sexual, o estar infectados con el VIH. Hay poca literatura disponible sobre el uso de las duchas rectales entre mujeres, pero parece ser menos frecuente que entre los hombres (32% vs. 70%). Los videos aconsejan usar 2 a 3 dosis de líquido y retenerlo por 10-30 segundos antes de expulsarlo. Estos resultados pueden informar el desarrollo de una ducha rectal segura y aceptable para la prevención del VIH.

Notes

Acknowledgements

The study was funded by a U19 Grant under the Integrated Preclinical-Clinical Program for HIV Topical Microbicides (IPCP-HTM), Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH) (AI113127). This work was also supported by a Center Grant from the NIMH to the HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University (P30-MH43520; PI: Remien, PhD). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Alex Carballo-Diéguez
    • 1
  • Cody Lentz
    • 1
  • Rebecca Giguere
    • 1
  • Edward J. Fuchs
    • 2
  • Craig W. Hendrix
    • 2
  1. 1.HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute and Columbia UniversityNew YorkUSA
  2. 2.Division of Clinical PharmacologyJohns Hopkins UniversityBaltimoreUSA

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