An Event-Level Comparison of Risk-Related Sexual Practices Between Black and Other-Race Men Who Have Sex with Men: Condoms, Semen, Lubricant, and Rectal Douching

Calabrese, Sarah K.; Rosenberger, Joshua G.; Schick, Vanessa; Novak, David S.; Reece, Michael

doi:10.1089/apc.2012.0355

Cited by 27 publications

(24 citation statements)

References 37 publications

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“…These findings are consistent with the small number of studies conducted on this topic and suggest that rectal douching with AI is a relatively common practice [18,22]. However, our study is one of the first to report on the content and type of rectal douches used for AI.…”

Section: Discussionsupporting

confidence: 91%

Prevalence and types of rectal douches used for anal intercourse: results from an international survey

et al. 2014

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BackgroundRectal products used with anal intercourse (AI) may facilitate transmission of STIs/HIV. However, there is limited data on rectal douching behavior in populations practicing AI. We examined the content, types of products, rectal douching practices and risk behaviors among those reporting AI.MethodsFrom August 2011 to May 2012, 1,725 women and men reporting receptive AI in the past 3 months completed an internet-based survey on rectal douching practices. The survey was available in English, French, German, Mandarin, Portuguese, Russian, Spanish, and Thai and included questions on sexual behaviors associated with AI including rectal douching. Differences by rectal douching practices were evaluated using chi-square methods and associations between reported douching practices and other factors including age and reported STI history were evaluated using logistic regression analysis.ResultsRespondents represented 112 countries, were mostly male (88%), and from North America (55%) or Europe (22%). Among the 1,339 respondents (66%) who reported rectal douching, most (83%) reported always/almost always douching before receptive AI. The majority of rectal douchers reported using non-commercial/homemade products (93%), with water being the most commonly used product (82%). Commercial products were used by 31%, with the most common product being saline-based (56%). Rectal douching varied by demographic and risk behaviors. The prevalence of rectal douching was higher among men (70% vs. 32%; p-value < .01), those reporting substance-use with sex (74% vs. 46%; p-value < .01), and those reporting an STI in the past year (69% vs. 57% p-value < .01) or ever testing HIV-positive (72% vs. 53%; p-value < .01). In multivariable analysis, adjusting for age, gender, region, condom and lubricant use, substance use, and HIV-status, douchers had a 74% increased odds of reporting STI in the past year as compared to non-douchers [adjusted odds ratio (AOR) = 1.74; 95% CI 1.01-3.00].ConclusionGiven that rectal douching before receptive AI is common and because rectal douching was associated with other sexual risk behaviors the contribution of this practice to the transmission and acquisition of STIs including HIV may be important.

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Section: Discussionsupporting

confidence: 91%

Prevalence and types of rectal douches used for anal intercourse: results from an international survey

et al. 2014

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“…These findings are consistent with those from previous studies conducted among MSM in other US cities (Calabrese, Rosenberger, Schick, Novak, & Reece, 2013; Carballo-Dieguez, O’Sullivan, et al, 2007; Carballo-Dieguez et al, 2000). Within most partnerships, commercial lubricant was applied by both partners during RAI at their last sexual event, yet participants in <5% of partnerships reported commercial lubricant use was bothersome and interrupted sex despite reapplication in 74% of partnerships.…”

Section: Discussionsupporting

confidence: 93%

Commercial lubricant use among HIV-negative men who have sex with men in Los Angeles: implications for the development of rectal microbicides for HIV prevention

et al. 2014

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To inform the development and assess potential use of rectal microbicide gels for HIV prevention among men who have sex with men (MSM), we examined the dynamics and contexts of commercial lubricant use during receptive anal intercourse (RAI) within this population. From 2007–2010, 168 HIV-negative MSM living in Los Angeles who practice RAI completed computer-assisted self-interviews, which collected information on their last sexual event with ≤3 recent partners, at baseline, 3 months, and 1 year study visits. Logistic generalized linear mixed models were used to identify individual- and sexual event-level characteristics associated with commercial lubricant use during RAI at the last sexual event within 421 partnerships reported by participants over the course of follow-up. During RAI at their last sexual event, 57% of partnerships used a condom and 69% used commercial lubricant. Among partnerships that used commercial lubricant, 56% reported lubricant application by both members of the partnership, 66% first applied lubricant during sex, but before penetration, and 98% applied lubricant at multiple locations. The relationship between substance use and commercial lubricant use varied by condom use (interaction p-value=0.01). Substance use was positively associated with commercial lubricant use within partnerships that used condoms during RAI at their last sexual event (adjusted odds ratio [AOR]=4.47, 95% confidence interval [CI]: 1.63–12.28), but no association was observed within partnerships that did not use condoms (AOR=0.66, 95% CI: 0.23–1.85). Commercial lubricant use during RAI was also positively associated with reporting more sexual partners (AOR=1.18, 95% CI: 1.05–1.31), while older age (units= 5 years) (AOR=0.75, 95% CI: 0.61–0.94), homelessness (past year) (AOR=0.32, 95% CI: 0.13–0.76), and having sex with an older (>10 years) partner (AOR=0.37, 95% CI: 0.14–0.95) were negatively associated with commercial lubricant use. These factors should be considered in the development of rectal microbicide gels to enhance their acceptability and use among MSM.

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“…Hispanic partnered MSM and partnered men in mixed or non-white same-sex relationships were more likely to use a rectal enema for HIV prevention. Uptake of a rectal enema for HIV prevention among minority male couples may prove to be very beneficial and effective since racial and ethnic minority MSM remain disproportionately affected by and at greater risk for HIV acquisition compared to their white counterparts [1, 39–41]. Once rectal microbicides become a viable method for HIV prevention, additional research will be needed to assess how best to educate racial and ethnic minority male couples about this option, as well as their uptake of it.…”

Section: Discussionmentioning

confidence: 99%

Anal Douche Practices and Willingness to Use a Rectal Microbicide Enema for HIV Prevention and Associated Factors Among an Internet Sample of HIV-Negative and HIV-Discordant Male Couples in the US

et al. 2015

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A significant proportion of MSM acquire HIV from their primary relationship partners. Rectal microbicides are currently being studied to determine their efficacy for HIV prevention, yet willingness to use rectal microbicides among male couples is largely unknown. Dyadic data from 333 HIV-negative and HIV-discordant male couples, representing 631 HIV-negative men, were used to assess anal douching practices and willingness to use a rectal microbicide for HIV prevention. 17% of men douched 100% of the time before having anal sex within their primary partner. Among those who had sex outside of their relationship, 36% had douched 100% of the time before having anal sex with a casual MSM partner. Most men (63%) indicated a willingness to use a theoretically effective rectal microbicide prior to anal sex for HIV prevention. If found effective, rectal microbicides delivered as an anal douche may be an acceptable format for HIV prevention to some MSM who already engage in anal douching. Understanding current douching practices will be important in successfully promoting the uptake of rectal microbicides.

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An Event-Level Comparison of Risk-Related Sexual Practices Between Black and Other-Race Men Who Have Sex with Men: Condoms, Semen, Lubricant, and Rectal Douching

Cited by 27 publications

References 37 publications

Prevalence and types of rectal douches used for anal intercourse: results from an international survey

Prevalence and types of rectal douches used for anal intercourse: results from an international survey

Commercial lubricant use among HIV-negative men who have sex with men in Los Angeles: implications for the development of rectal microbicides for HIV prevention

Anal Douche Practices and Willingness to Use a Rectal Microbicide Enema for HIV Prevention and Associated Factors Among an Internet Sample of HIV-Negative and HIV-Discordant Male Couples in the US

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