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Insert Discourse: Rectal Douching Among Young HIV-Positive and HIV-Negative Men Who Have Sex with Men in Vancouver, Canada

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Abstract

Douching is a common practice among certain groups of women and MSM, and it is conducted for the purpose of cleanliness as part of bodily hygiene maintenance. Although there has been considerable research about female vaginal douching, understandings of rectal douching (RD) for MSM are limited. In the epidemiological and medical literature, RD is presented as a behaviour that removes beneficial bacteria and the surface epithelium layer of the colon, which can, potentially, increase the risk of HIV transmission in MSM. The paucity of research on male douching practices is curious given the primacy of anal sex in HIV prevention initiatives and the widespread nature of rectal douching among this population. This paper provides preliminary data on RD and is intended to engender a dialogue about male douching and the need for additional research into the cultural construction of the body among MSM, namely with respect to the anus. Findings were derived from qualitative interviews with 12 young HIV-positive men who had recently become HIV-infected and 12 HIV-negative age-matched counterparts who were participating in a prospective cohort study. Beliefs about RD differed according to HIV serostatus; HIV-positive men discussed the practice much more openly than their counterparts did. Pre-coital RD is an embedded behaviour about which very little is known. However, it is a critical issue to include in the development of effective HIV prevention strategies and warrants an acknowledgement of importance of the anus in the lives, sexual practices, and identities among MSM.

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Acknowledgments

We acknowledge the generosity of the participants who shared their experiences, and all the other investigators and staff. This paper is dedicated to the memory of Bonnie Devlin, the project research administrator and ardent supporter of this study, who passed away as a result of breast cancer in 2008. This study was in part supported by a grant from the Canadian Institutes for Health Research for Dr. Robert. S. Hogg.

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Authors and Affiliations

  1. British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada

    Arn J. Schilder, Treena R. Orchard, Steffanie A. Strathdee & Robert S. Hogg

  2. Faculty of Health Sciences, School of Health Studies, University of Western Ontario, 208-Arthur and Sonia Labatt Health Sciences Building, London, ON, N6A 5B9, Canada

    Treena R. Orchard

  3. Vancouver and Coastal Health, Vancouver, BC, Canada

    Christopher S. Buchner

  4. Division of Global Public Health, Department of Medicine, University of California San Diego School of Medicine, San Diego, CA, USA

    Steffanie A. Strathdee

  5. Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada

    Robert S. Hogg

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  1. Arn J. Schilder
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Correspondence to Treena R. Orchard.

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Schilder, A.J., Orchard, T.R., Buchner, C.S. et al. Insert Discourse: Rectal Douching Among Young HIV-Positive and HIV-Negative Men Who Have Sex with Men in Vancouver, Canada. Sexuality & Culture 14, 327–343 (2010). https://doi.org/10.1007/s12119-010-9077-7

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