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Rectal Douching and Microbicide Acceptability among Young Men who Have Sex with Men

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Abstract

Men who have sex with men (MSM) commonly report engaging in rectal douching (RD) practices prior to receptive anal intercourse. Researchers are interested in the possibility of designing a RD with a microbicide component. In our analyses, we examined whether YMSM who engaged in RD behaviors differ in HIV prevention behaviors from their non-RD peers. We then examined whether RD frequency was associated with rectal microbicide acceptability. Half the participants (47.8%) reported having ever douched. Participants were more likely to douche if they were racial/ethnic minorities (AOR = 2.24, p = 0.02) and had recently tested for HIV (AOR = 1.96, p = 0.04). Greater douching frequency was associated with racial/ethnic minorities (β = 0.20, p = 0.009) and recent HIV testing (β = 0.19, p < 0.01). Participants who reported frequently douching indicated greater microbicide acceptability (β = 0.32, p < 0.001). Designing behaviorally congruent products remains a priority in next generation Pre-Exposure Prophylaxis (PrEP) and a rectal douche might be an additional tool if found to be efficacious.

Resumen

Los hombres que tienen sexo con otros hombres (MSM) comúnmente utilizan duchas rectales (RD) antes de tener sexo anal receptivo. Ante la posibilidad de diseñar una ducha rectal con un componente microbicida, examinamos si los jóvenes MSM (YMSM) que usan RD difieren en las conductas de prevención del VIH cuando son comparados con pares que no usan RD. Además examinamos si la frecuencia de RD estaba asociada con la aceptabilidad de microbicidas rectales. La mitad de los participantes (47.8%) informaron haber usado RD. Los participantes con mayor propensidad a usar RD fueron las minorías raciales/étnicas (AOR = 2.24, p = .02) y aquellos YMSM que habían realizado una prueba de VIH recientemente (AOR = 1.96, p = .04). Mayor frecuencia en el uso de RD se asoció con ser una minoría racial/étnica (β = .20, p = .009) y entre aquellos quienes tuvieron una prueba reciente de VIH (β = .19, p <.01). Los participantes que informaron el uso de RD con mayor frecuencia indicaron una mayor aceptabilidad de los microbicidas (β = .32, p <.001). El diseño de productos conductualmente congruentes sigue siendo una prioridad en el desarrollo de la nueva generación de productos con profilaxis antes de la exposición (PrEP) y una ducha rectal podría ser una herramienta adicional si se considera eficaz en un futuro.

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Acknowledgements

We greatly appreciate the hard work of the study staff, and are indebted to the study participants for volunteering their time. This research was sponsored by the US National Institutes of Health (NIH), under R34 MH101997. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH.

Funding

This study is supported by a R34 grand from the National Institute of Mental Health (R34MH101997-01A1). Views expressed in this manuscript do not necessarily represent the views of the funding agency.

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  1. Department of Family and Community Health, School of Nursing, University of Pennsylvania, 418 Curie Blvd., Suite 222L, Philadelphia, PA, USA

    Ryan C. Tingler, Daniel Connochie & José A. Bauermeister

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  1. Ryan C. Tingler
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  2. Daniel Connochie
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  3. José A. Bauermeister
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Correspondence to José A. Bauermeister.

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Tingler, R.C., Connochie, D. & Bauermeister, J.A. Rectal Douching and Microbicide Acceptability among Young Men who Have Sex with Men. AIDS Behav 24, 1414–1421 (2020). https://doi.org/10.1007/s10461-019-02662-x

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