Rectal Douching Among Men Who Have Sex with Men in Paris: Implications for HIV/STI Risk Behaviors and Rectal Microbicide Development

Hambrick, H. Rhodes; Park, Su Hyun; Goedel, William C.; Morganstein, Jace G.; Kreski, Noah T.; Mgbako, Ofole; Duncan, Dustin T.

doi:10.1007/s10461-017-1873-8

Cited by 21 publications

(28 citation statements)

References 41 publications

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“…As reported in prior research, 18 in October 2016 we surveyed users of a popular GSN smartphone application among MSM via broadcast announcements in the Paris metropolitan area; 580 MSM completed the survey. After obtaining sociodemographic information (age, employment status, born in France or elsewhere, sexual orientation, relationship status), we assessed the following during the previous 3 months: popper use (any vs none), use of drugs or alcohol during sex (none, any, three to five times, six or more times), condomless insertive and receptive intercourse (any vs none) and group sex (never, within the past 3 months, before the past 3 months).…”

Section: Methodsmentioning

confidence: 99%

Use of poppers and HIV risk behaviours among men who have sex with men in Paris, France: an observational study

et al. 2018

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The use of inhaled nitrites, or poppers, among men who have sex with men (MSM) is prevalent, yet has been associated with HIV seroconversion. We surveyed 580 MSM from a geosocial networking smartphone application in Paris, France, in 2016. Of the respondents, 46.7% reported popper use within the previous 3 months. Regression models adjusted for sociodemographic characteristics found that the use of poppers was significantly (P<0.05) associated with the following during the prior 3 months: condomless anal intercourse (adjusted relative risk (aRR) 1.27, 95% confidence interval (CI) 1.07-1.50), use of alcohol and/or drugs during sex once or twice (adjusted relative risk ratio (aRRR) 2.33, 95% CI 1.44-2.03), three to five times (aRRR 5.41, 95% CI 2.98-9.84) or six or more times (aRRR 4.09, 95% CI 2.22-7.56), participation in group sex (aRRR 3.70, 95% CI 2.33-5.90) and self-reported diagnosis with any sexually transmissible infection over the previous year (aRR 1.63, 95% CI 1.18-2.27), specifically chlamydia (aRR 2.75, 95% CI 1.29-4.29) and syphilis (aRR 2.27, 95% CI 1.29-4.29).

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Section: Methodsmentioning

confidence: 99%

Use of poppers and HIV risk behaviours among men who have sex with men in Paris, France: an observational study

et al. 2018

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“…These types of apps have rapidly been adopted as a means for GBM to meet sex partners, and offer important opportunities as recruitment venues for sexual health research studies. 9,[23][24][25][26][27][28][29] Despite the internet's and, more recently, apps' suitability for researchers to engage large numbers of geographically diverse GBM, 12,[30][31][32][33] public health researchers and practitioners remain concerned about adequate representation of those most vulnerable to HIV, including younger GBM and persons of color. 9,34 Historically, persons of color have been harder to recruit, engage, and retain in research studies, [35][36][37] and online-recruited studies have observed greater attrition among men of color during consecutive follow-up assessments.…”

Section: Introductionmentioning

confidence: 99%

Recruiting vulnerable populations to participate in HIV prevention research: findings from the Together 5000 cohort study

Grov

Westmoreland²,

Carneiro

et al. 2019

Annals of Epidemiology

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PURPOSE: To examine factors associated with completing enrollment milestones in the Together 5,000 cohort of at-risk men (n = 8661), transmen (n = 53), and transwomen (n = 63) who have sex with men. METHODS: Between 2017-2018, participants completed an online enrollment survey and were offered opportunities to complete an incentivized secondary online survey as well as selfadministered at-home HIV testing (OraSure HIV-1 Oral specimen collection device). We explored factors associated with completing each study component. RESULTS: In total, 8,777 individuals completed our enrollment survey, 6,166 (70.3%) completed the secondary survey, and 5,010 returned the at-home HIV test kit that was mailed to them (81.3% of those mailed a kit). Consistent with other researchers, in our multivariable models, those who were White, with more years of education, were more likely to complete study components, although the magnitude of these associations was small. For example, 50.9% of those enrolled, 47.9% of those completing the secondary survey, and 46.8% of those completing HIV testing were persons of color-a statistically significant, but meaningfully insignificant decline. CONCLUSIONS: These findings highlight the ongoing need for researchers to identify barriers that may prevent persons of color and younger individuals from participating in research studies.

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“…These figures suggest that RD might be a common practice among MSM in urban China whatever their economic level. The prevalence of RD behavior among MSM in China is close to that of the USA (66%), Kenya (63%) [5,6], the UK, Brazil, and France (53.4-54.3%) [4,7,8], but greater than that in Peru (18.2-27.0%) [17,18] and the Netherlands (13.6-46%) [19,20]. Despite this high prevalence among MSM worldwide, scientific data for and knowledge of RD in the Chinese MSM population is still poor.…”

Section: Discussionmentioning

confidence: 86%

“…Men who have sex with men (MSM) are disproportionately affected by HIV in China and many other countries [1][2][3]. Understanding the sexual behaviors and preferences of this key population group is essential for developing effective prevention strategies [4]. In recent years, the rectal douching (RD) behavior of MSM has received widespread attention.…”

Section: Introductionmentioning

confidence: 99%

“…In two studies, around 66% and 63% of MSM in the USA and Kenya, respectively, were found to have conducted RD [5,6]. The percentages of MSM employing RD hover around 53.4-54.0% in the UK, Brazil, and France [4,7,8]. In Peru, the Netherlands, and China (Beijing City), the prevalence of RD among MSM is 18.2-27.0%, 13.6-46.0%, and 59.0%, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Rectal douching before sexual intercourse and inappropriate douching tool use associated with increased HIV infection among men who have sex with men: a cross-sectional study from Shenyang, China

Chu¹,

Shen²,

Hu³

et al. 2020

Preprint

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Background: Rectal douching (RD) is widely practiced by men who have sex with men (MSM), and is correlated with increased risk of HIV infection. However, the mechanism of how RD increases the risk of HIV infection is not well understood, and there is limited data on RD behavior in MSM practicing anal sex in China. We examine the purpose of RD, its timing in relation to anal sex, the types of RD products used, and risky sexual behaviors among MSM reporting anal sex.Methods: Between August 2017 and December 2018, a cross-sectional study was conducted among adult MSM in Shenyang, China. Data were collected on demographics, sexual behaviors, and RD for the most recent sexual intercourse by means of interviewer-administered face-to-face questionnaires. Blood samples were collected to test for antibodies to HIV and syphilis. Multivariable logistic regression models were used to assess the risk factors associated with HIV infection.Results: A total of 515 eligible MSM participated in this survey (median age: 31 years). During the most recent anal intercourse, 28.3% (146/515) had condomless receptive anal intercourse (CRAI), 21.4% (110/515) practiced serosorting, and more than half (61.6%, 317/515) reported RD before or after anal sex. Of those practicing RD, 96.8% (307/317) conducted RD before sex, while 62.5% (198/317) conducted RD after sex. The douching devices used were primarily shower hoses (85.3%, 262/307), and relatively few MSM used commercial RD products (8.1%). The prevalence of HIV-1 and syphilis was 11.7% and 13.2%, respectively. HIV infection was positively associated with RD (adjusted odds ratio (AOR), 2.8; 95% confidence interval (CI), 1.4-5.5), practicing RD before sex (AOR, 2.3; 95% CI, 1.2–4.3), practicing RD after sex (AOR, 1.8; 95% CI, 1.0–3.1), using a shower hose for RD (AOR, 3.5; 95% CI, 1.1–13.0), condomless receptive anal intercourse (CRAI) (AOR, 2.9; 95% CI, 1.6–5.5), and using nitrite inhalants (AOR, 2.8; 95 % CI, 1.6-5.1) in the most recent anal intercourse.Conclusions: RD is popular among Chinese MSM. Improper noncommercial RD tools increase the rates of HIV infection. Public health workers and the MSM community should publicize scientific knowledge and prevention approaches relating to RD and HIV transmission to MSM, and we recommend that better tools be offered to assist in RD in order to decrease the risk of acquiring HIV.

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Rectal Douching Among Men Who Have Sex with Men in Paris: Implications for HIV/STI Risk Behaviors and Rectal Microbicide Development

Cited by 21 publications

References 41 publications

Use of poppers and HIV risk behaviours among men who have sex with men in Paris, France: an observational study

Use of poppers and HIV risk behaviours among men who have sex with men in Paris, France: an observational study

Recruiting vulnerable populations to participate in HIV prevention research: findings from the Together 5000 cohort study

Rectal douching before sexual intercourse and inappropriate douching tool use associated with increased HIV infection among men who have sex with men: a cross-sectional study from Shenyang, China

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