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.
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.
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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.
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Carballo-Diéguez, A., Lentz, C., Giguere, R. et al. Rectal Douching Associated with Receptive Anal Intercourse: A Literature Review. AIDS Behav 22, 1288–1294 (2018). https://doi.org/10.1007/s10461-017-1959-3
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DOI: https://doi.org/10.1007/s10461-017-1959-3