Getting Clear About Rectal Douching Among Men Who Have Sex With Men

Grov, Christian; Westmoreland, Drew; Carneiro, Pedro B.; Bauermeister, José A.

doi:10.1007/s10508-021-01933-w

Cited by 5 publications

(4 citation statements)

References 35 publications

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“…Sample characteristics are noted in Table 1. Participants' mean age was 21 (range: [16][17][18][19][20][21][22][23][24]. Most participants identified as racial/ethnic minorities (n = 12, 60%) and 75% selfidentified as gay.…”

Section: Resultsmentioning

confidence: 99%

“…While there has been a recent five-fold increase in PrEP uptake among adult MSM in urban areas in the US [1], adolescents account for less than 1% of new PrEP prescriptions [2,3]. This trend is particularly troubling, as young MSM (YMSM; ages [13][14][15][16][17][18][19][20][21][22][23][24] account for nearly one-third of new infections among MSM in the US [4]. Despite their high PrEP need, only 3% of eligible YMSM have been prescribed PrEP, substantially lower than their older peers [5,6]; PrEP uptake among YMSM under 18 years old is even lower, contributing to continued HIV transmission among this group [2].…”

Section: Introductionmentioning

confidence: 99%

“…These next generation PrEP formulations include diverse drug delivery mechanisms (e.g., douches, injectables, implants) that could expand users' HIV prevention choices based on their sociocultural context, behavioral patterns, and desire for episodic or long-acting protection [20]. For example, rectal douches may be congruent with cleansing practices and behaviors regarded as normative prior to participating in activities where the probability of engaging in receptive anal intercourse is high [21,22]. Similarly, infrequent injectable formulations or episodic oral PrEP might be more compatible with a complex lifestyle where taking a pill every day is unrealistic.…”

Section: Introductionmentioning

confidence: 99%

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PrEParing for NextGen: Cognitive Interviews to Improve Next Generation PrEP Modality Descriptions for Young Men Who have Sex with Men

et al. 2021

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Next generation PrEP formulations may circumvent factors that impede daily oral pre-exposure prophylaxis (PrEP) use among young men who have sex with men (YMSM). We conducted video-based cognitive interviews with 20 YMSM (age 16-24) recruited in the US Northeast to assess participants' attitudes and comprehension of written descriptions of next generation PrEP modalities. Participants were predominately racial/ethnic minorities and half used daily oral PrEP. We identified four main areas for improvement of descriptions: defining scientific terms and balancing medical jargon and casual language; referencing more established products to contextualize PrEP formulations (e.g., hormonal implants); ensuring clarity and reducing redundancy; and including imagery (e.g., rectal douche applicator). The refined descriptions serve as exemplar text that may be used in future studies examining YMSM's preferences across next generation PrEP modalities. Accurate descriptions of next generation PrEP products strengthen measurement accuracy and can help roll-out products that become approved for clinical use. Keywords Gay and bisexual men • Adolescents • Pre-exposure prophylaxis • Instrument development • Cognitive interviewing ResumenLas formulaciones de próxima generación para la profilaxis pre-exposición (PrEP) pueden eludir los factores que impiden el uso diario del PrEP oral en hombres jóvenes que tienen relaciones sexuales con hombres (YMSM). Realizamos entrevistas cognitivas usando videoconferencia con 20 YMSM (de 16 a 24 años) reclutados del noreste de los Estados Unidos con el fin de evaluar sus actitudes y su comprensión de las definiciones desarrolladas para describir las modalidades de PrEP de próxima generación. Los participantes eran predominantemente minorías raciales/étnicas y la mitad usaba PrEP oral diariamente. Identificamos cuatro áreas principales para mejorar las descripciones: definir términos científicos y equilibrar la

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

PrEParing for NextGen: Cognitive Interviews to Improve Next Generation PrEP Modality Descriptions for Young Men Who have Sex with Men

et al. 2021

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“…When features were considered in isolation, the enema emerged as the most preferred modality. The endorsement of the enema as the most preferred modality for an RM candidate is in alignment with existing sexual behaviour patterns, as sexual and gender minorities (SGM) report the use of enemas prior to anal sex [ 13 , 23 , 30 , 31 ]. Nevertheless, if an enema were not an option, participants were more willing to prefer the insert when compared to the suppository when designing a combination product.…”

Section: Discussionmentioning

confidence: 99%

A conjoint experiment of three placebo rectal products used with receptive anal sex: results from MTN‐035

Bauermeister,

Lin,

Tingler

et al. 2024

J Int AIDS Soc.

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IntroductionEnd‐user perspectives are vital to the design of new biomedical HIV prevention products. Conjoint analysis can support the integration of end‐user perspectives by examining their preferences of potential pre‐exposure prophylaxis (PrEP) products. The Microbicides Trial Network (MTN) 035 protocol examined three placebo rectal dosage forms (insert, enema and suppository) that could deliver PrEP prior to receptive anal sex (RAS).MethodsBetween April 2019 and July 2020, we enrolled 217 HIV‐negative, cisgender men who have sex with men (MSM; n = 172; 79.3%) and transgender people (n = 47; 20.7%) ages 18–35 into a randomized cross‐over trial across Malawi, Peru, South Africa, Thailand and the United States. Participants used each product prior to RAS over 4‐week periods. Participants completed a conjoint experiment where they selected between random profiles using seven features (dosage form, timing of use before sex, side effects, duration of protection, effectiveness, frequency of use and need for a prescription).ResultsEffectiveness was the strongest determinant of choice (30.4%), followed by modality (18.0%), potential side effects (17.2%), frequency of use (10.8%), duration of protection (10.4%), timing of use before sex (7.4%) and need for a prescription (5.9%). Relative utility scores indicated that the most desirable combination of attributes was a product with 95% efficacy, used 30 minutes before sex, offering a 3‐ to 5‐day protection window, used weekly, having no side effects, in the form of an enema and available over‐the‐counter.ConclusionsChoice in next‐generation PrEP products is highly desired by MSM and transgender people, as no one‐size‐fits‐all approach satisfies all the preferences. MTN‐035 participants weighed product features differently, recognizing the need for diverse, behaviourally congruent biomedical options that fit the needs of intended end‐users.

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History of Rectal Product Use and Country of Residence Influence Preference for Rectal Microbicide Dosage Forms Among Young Sexual and Gender Minorities: A Multi-country Trial Comparing Placebo Douche, Suppository, and Insert Products

Giguere,

Balán,

Kutner

et al. 2024

AIDS Behav

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Getting Clear About Rectal Douching Among Men Who Have Sex With Men

Cited by 5 publications

References 35 publications

PrEParing for NextGen: Cognitive Interviews to Improve Next Generation PrEP Modality Descriptions for Young Men Who have Sex with Men

PrEParing for NextGen: Cognitive Interviews to Improve Next Generation PrEP Modality Descriptions for Young Men Who have Sex with Men

A conjoint experiment of three placebo rectal products used with receptive anal sex: results from MTN‐035

History of Rectal Product Use and Country of Residence Influence Preference for Rectal Microbicide Dosage Forms Among Young Sexual and Gender Minorities: A Multi-country Trial Comparing Placebo Douche, Suppository, and Insert Products

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