Skip to main content
Top
Published in: AIDS and Behavior 11/2016

01-11-2016 | Original Paper

Rectal Douching Prevalence and Practices Among Peruvian Men Who have Sex with Men and Transwomen: Implications for Rectal Microbicides

Authors: Jerome T. Galea, Janni J. Kinsler, Sarah McLean, Gino Calvo, Hugo Sánchez, Segundo R. Leon, Brandon Brown

Published in: AIDS and Behavior | Issue 11/2016

Login to get access

Abstract

Peruvian men who have sex with men (MSM) and transwomen (TW) could benefit from a rectal microbicide (RM) formulated as a rectal douche to prevent HIV infection. However, little is known about rectal douching practices among Peruvian MSM and TW, information necessary to inform RM douche development and future uptake. Using a self-administered interview, we examined the prevalence of and factors associated with rectal douching among a convenience sample of 415 Peruvian MSM and 68 TW. In the previous 6 months, 18 % of participants reported rectal douching using pre-filled commercial kits or plastic bottles or enema bags filled with water, water/soap or saltwater. Multivariate logistic analysis found that “equally insertive and receptive” or “exclusively/mainly receptive” sex roles were associated with douche use. Rectal douching among Peruvian MSM and TW is similar to reports from other studies and supports the potential uptake of a douche-formulated RM in these populations.
Literature
1.
go back to reference Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.PubMedPubMedCentralCrossRef Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.PubMedPubMedCentralCrossRef
2.
go back to reference McCormack S, Dunn D. Pragmatic open-label randomised trial of preexposure prophylaxis: the proud study [abstract 22LB]. Abstract presented at: Conference on Retroviruses and Opportunistic Infections (CROI); February 23–26, 2015; Seattle, Washington. McCormack S, Dunn D. Pragmatic open-label randomised trial of preexposure prophylaxis: the proud study [abstract 22LB]. Abstract presented at: Conference on Retroviruses and Opportunistic Infections (CROI); February 23–26, 2015; Seattle, Washington.
3.
go back to reference Grant RM, Anderson PL, McMahan VM, et al. Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infect Dis. 2014;14(9):820–9.PubMedCrossRef Grant RM, Anderson PL, McMahan VM, et al. Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infect Dis. 2014;14(9):820–9.PubMedCrossRef
4.
go back to reference Molina JM, Capitant C, Charreau I, Spire B et al. On demand PrEP With Oral TDF-FTC in MSM: results of the ANRS Ipergay trial [abstract 23LB]. Abstract presented at: Conference on Retroviruses and Opportunistic Infections (CROI); February 23–26, 2015; Seattle, Washington. Molina JM, Capitant C, Charreau I, Spire B et al. On demand PrEP With Oral TDF-FTC in MSM: results of the ANRS Ipergay trial [abstract 23LB]. Abstract presented at: Conference on Retroviruses and Opportunistic Infections (CROI); February 23–26, 2015; Seattle, Washington.
5.
go back to reference Krakower DS, Mayer KH. Pre-exposure prophylaxis to prevent HIV infection: current status, future opportunities and challenges. Drugs. 2015;75(3):243–51.PubMedPubMedCentralCrossRef Krakower DS, Mayer KH. Pre-exposure prophylaxis to prevent HIV infection: current status, future opportunities and challenges. Drugs. 2015;75(3):243–51.PubMedPubMedCentralCrossRef
6.
go back to reference Peinado J, Lama JR, Galea JT, et al. Acceptability of oral versus rectal HIV preexposure prophylaxis among men who have sex with men and transgender women in Peru. J Int Assoc Provid AIDS Care. 2013;12(4):278–83.PubMedCrossRef Peinado J, Lama JR, Galea JT, et al. Acceptability of oral versus rectal HIV preexposure prophylaxis among men who have sex with men and transgender women in Peru. J Int Assoc Provid AIDS Care. 2013;12(4):278–83.PubMedCrossRef
7.
go back to reference Gomez GB, Borquez A, Caceres CF, et al. The potential impact of pre-exposure prophylaxis for HIV prevention among men who have sex with men and transwomen in Lima, Peru: a mathematical modelling study. PLoS Med. 2012;9(10):e1001323.PubMedPubMedCentralCrossRef Gomez GB, Borquez A, Caceres CF, et al. The potential impact of pre-exposure prophylaxis for HIV prevention among men who have sex with men and transwomen in Lima, Peru: a mathematical modelling study. PLoS Med. 2012;9(10):e1001323.PubMedPubMedCentralCrossRef
8.
go back to reference Beyrer C, Sullivan P, Millett G, Sanchez J, et al. The increase in global HIV epidemics MSM. AIDS. 2013;27(17):2665–78.PubMedCrossRef Beyrer C, Sullivan P, Millett G, Sanchez J, et al. The increase in global HIV epidemics MSM. AIDS. 2013;27(17):2665–78.PubMedCrossRef
9.
go back to reference Galea JT, Kinsler JJ, Imrie J, et al. Preparing for rectal microbicides: sociocultural factors affecting product uptake among potential South American users. Am J Public Health. 2014;104(6):e113–20.PubMedPubMedCentralCrossRef Galea JT, Kinsler JJ, Imrie J, et al. Preparing for rectal microbicides: sociocultural factors affecting product uptake among potential South American users. Am J Public Health. 2014;104(6):e113–20.PubMedPubMedCentralCrossRef
10.
go back to reference Newman PA, Roungprakhon S, Tepjan S. A social ecology of rectal microbicide acceptability among young men who have sex with men and transgender women in Thailand. J Int AIDS Soc. 2013;1(16):18476. Newman PA, Roungprakhon S, Tepjan S. A social ecology of rectal microbicide acceptability among young men who have sex with men and transgender women in Thailand. J Int AIDS Soc. 2013;1(16):18476.
11.
go back to reference Pines HA, Gorbach PM, Weiss RE, et al. Acceptability of potential rectal microbicide delivery systems for HIV prevention: a randomized crossover trial. AIDS Behav. 2013;17(3):1002–15.PubMedPubMedCentralCrossRef Pines HA, Gorbach PM, Weiss RE, et al. Acceptability of potential rectal microbicide delivery systems for HIV prevention: a randomized crossover trial. AIDS Behav. 2013;17(3):1002–15.PubMedPubMedCentralCrossRef
12.
go back to reference Carballo-Diéguez A, Exner T, Dolezal C, Pickard R, Lin P, Mayer KH. Rectal microbicide acceptability: results of a volume escalation trial. Sex Transm Dis. 2007;34(4):224–9.PubMedCrossRef Carballo-Diéguez A, Exner T, Dolezal C, Pickard R, Lin P, Mayer KH. Rectal microbicide acceptability: results of a volume escalation trial. Sex Transm Dis. 2007;34(4):224–9.PubMedCrossRef
13.
go back to reference Kinsler JJ, Cunningham WE, Nureña CR, et al. Using conjoint analysis to measure the acceptability of rectal microbicides among men who have sex with men in four South American cities. AIDS Behav. 2012;16(6):1436–47.PubMedCrossRef Kinsler JJ, Cunningham WE, Nureña CR, et al. Using conjoint analysis to measure the acceptability of rectal microbicides among men who have sex with men in four South American cities. AIDS Behav. 2012;16(6):1436–47.PubMedCrossRef
15.
go back to reference Javanbakht M, Murphy R, Gorbach P, LeBlanc MA, Pickett J. Preference and practices relating to lubricant use during anal intercourse: implications for rectal microbicides. Sex Health. 2010;7(2):193–8.PubMedCrossRef Javanbakht M, Murphy R, Gorbach P, LeBlanc MA, Pickett J. Preference and practices relating to lubricant use during anal intercourse: implications for rectal microbicides. Sex Health. 2010;7(2):193–8.PubMedCrossRef
16.
go back to reference Kinsler JJ, Galea JT, Peinado J, Segura P, Montano SM, Sánchez J. Lubricant use among men who have sex with men reporting receptive anal intercourse in Peru: implications for rectal microbicides as an HIV prevention strategy. Int J STD AIDS. 2010;21(8):567–72.PubMedCrossRef Kinsler JJ, Galea JT, Peinado J, Segura P, Montano SM, Sánchez J. Lubricant use among men who have sex with men reporting receptive anal intercourse in Peru: implications for rectal microbicides as an HIV prevention strategy. Int J STD AIDS. 2010;21(8):567–72.PubMedCrossRef
17.
go back to reference Carballo-Diéguez A, Bauermeister JA, Ventuneac A, Dolezal C, Balan I, Remien RH. The use of rectal douches among HIV-uninfected and infected men who have unprotected receptive anal intercourse: implications for rectal microbicides. AIDS Behav. 2008;12(6):860–6.PubMedCrossRef Carballo-Diéguez A, Bauermeister JA, Ventuneac A, Dolezal C, Balan I, Remien RH. The use of rectal douches among HIV-uninfected and infected men who have unprotected receptive anal intercourse: implications for rectal microbicides. AIDS Behav. 2008;12(6):860–6.PubMedCrossRef
18.
go back to reference Carballo-Diéguez A, Bauermeister J, Ventuneac A, Dolezal C, Mayer K. Why rectal douches may be acceptable rectal-microbicide delivery vehicles for men who have sex with men. Sex Trans Dis. 2010;37(4):228–33. Carballo-Diéguez A, Bauermeister J, Ventuneac A, Dolezal C, Mayer K. Why rectal douches may be acceptable rectal-microbicide delivery vehicles for men who have sex with men. Sex Trans Dis. 2010;37(4):228–33.
19.
go back to reference Galea JT, Kinsler JJ, Imrie J, Nureña CR, Sanchez J, Cunningham WE. Rectal douching and implications for rectal microbicides among populations vulnerable to HIV in South America: a qualitative study. Sex Transm Infect. 2014;90(1):33–5.PubMedCrossRef Galea JT, Kinsler JJ, Imrie J, Nureña CR, Sanchez J, Cunningham WE. Rectal douching and implications for rectal microbicides among populations vulnerable to HIV in South America: a qualitative study. Sex Transm Infect. 2014;90(1):33–5.PubMedCrossRef
20.
go back to reference Noor SW, Rosser BR. Enema use among men who have sex with men: a behavioral epidemiologic study with implications for HIV/STI prevention. Arch Sex Behav. 2014;43(4):755–69.PubMedCrossRef Noor SW, Rosser BR. Enema use among men who have sex with men: a behavioral epidemiologic study with implications for HIV/STI prevention. Arch Sex Behav. 2014;43(4):755–69.PubMedCrossRef
21.
go back to reference Javanbakht M, Stahlman S, Pickett J, LeBlanc MA, Gorbach PM. Prevalence and types of rectal douches used for anal intercourse: results from an international survey. BMC Infect Dis. 2014;14:95.PubMedPubMedCentralCrossRef Javanbakht M, Stahlman S, Pickett J, LeBlanc MA, Gorbach PM. Prevalence and types of rectal douches used for anal intercourse: results from an international survey. BMC Infect Dis. 2014;14:95.PubMedPubMedCentralCrossRef
22.
23.
go back to reference Baral SD, Poteat T, Stromdahl S, Wirtz AL, Guadamuz TE, Beyrer C. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13(3):214–22.PubMedCrossRef Baral SD, Poteat T, Stromdahl S, Wirtz AL, Guadamuz TE, Beyrer C. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13(3):214–22.PubMedCrossRef
24.
go back to reference Beyrer C, Baral SD, Walker D, Wirtz AL, Johns B, Sifakis F. The expanding epidemics of HIV type 1 among men who have sex with men in low- and middle-income countries: diversity and consistency. Epidemiol Rev. 2010;32(1):137–51.PubMedCrossRef Beyrer C, Baral SD, Walker D, Wirtz AL, Johns B, Sifakis F. The expanding epidemics of HIV type 1 among men who have sex with men in low- and middle-income countries: diversity and consistency. Epidemiol Rev. 2010;32(1):137–51.PubMedCrossRef
27.
go back to reference Kinsler JJ, Galea JT, Lama JR, et al. Rectal douching among Peruvian men who have sex with men, and acceptability of a douche-formulated rectal microbicide to prevent HIV infection. Sex Transm Infect. 2013;89(1):62.PubMedCrossRef Kinsler JJ, Galea JT, Lama JR, et al. Rectal douching among Peruvian men who have sex with men, and acceptability of a douche-formulated rectal microbicide to prevent HIV infection. Sex Transm Infect. 2013;89(1):62.PubMedCrossRef
28.
go back to reference Brown B, Davtyan M, Leon SR, et al. A prospective cohort study characterising the role of anogenital warts in HIV acquisition among men who have sex with men: a study protocol. BMJ Open. 2014;4(9):e005687.PubMedPubMedCentralCrossRef Brown B, Davtyan M, Leon SR, et al. A prospective cohort study characterising the role of anogenital warts in HIV acquisition among men who have sex with men: a study protocol. BMJ Open. 2014;4(9):e005687.PubMedPubMedCentralCrossRef
29.
go back to reference Schilder A, Orchard TR, Buchner CS, Strathdee SA, Hogg RS. Insert discourse: rectal douching among young HIV-positive and HIV-negative men who have sex with men in Vancouver. Can Sex Cult. 2010;14(4):327–43.CrossRef Schilder A, Orchard TR, Buchner CS, Strathdee SA, Hogg RS. Insert discourse: rectal douching among young HIV-positive and HIV-negative men who have sex with men in Vancouver. Can Sex Cult. 2010;14(4):327–43.CrossRef
31.
go back to reference Schmelzer M, Schiller LR, Meyer R, Rugari SM, Case P. Safety and effectiveness of large-volume enema solutions. Appl Nurs Res. 2004;17(4):265–74.PubMed Schmelzer M, Schiller LR, Meyer R, Rugari SM, Case P. Safety and effectiveness of large-volume enema solutions. Appl Nurs Res. 2004;17(4):265–74.PubMed
32.
go back to reference de Vries HJ, van der Bij AK, Fennema JS, et al. Lymphogranuloma venereum proctitis in men who have sex with men is associated with anal enema use and high-risk behavior. Sex Trans Dis. 2008;35(2):203–8.CrossRef de Vries HJ, van der Bij AK, Fennema JS, et al. Lymphogranuloma venereum proctitis in men who have sex with men is associated with anal enema use and high-risk behavior. Sex Trans Dis. 2008;35(2):203–8.CrossRef
33.
go back to reference Schreeder MT, Thompson SE, Hadler SC, et al. Hepatitis B in homosexual men: prevalence of infection and factors related to transmission. J Infect Dis. 1982;146(1):7–15.PubMedCrossRef Schreeder MT, Thompson SE, Hadler SC, et al. Hepatitis B in homosexual men: prevalence of infection and factors related to transmission. J Infect Dis. 1982;146(1):7–15.PubMedCrossRef
34.
go back to reference Ndimbie OK, Kingsley LA, Nedjar S, Rinaldo CR. Hepatitis C virus infection in a male homosexual cohort: risk factor analysis. Genitourin Med. 1996;72(3):213–6.PubMedPubMedCentral Ndimbie OK, Kingsley LA, Nedjar S, Rinaldo CR. Hepatitis C virus infection in a male homosexual cohort: risk factor analysis. Genitourin Med. 1996;72(3):213–6.PubMedPubMedCentral
35.
go back to reference Heiligenberg M, Rijnders B, van der Loeff MFs, et al. High prevalence of sexually transmitted infections in HIV-infected men during routine outpatient visits in The Netherlands. Sex Trans Dis. 2012;39(1):8–15.CrossRef Heiligenberg M, Rijnders B, van der Loeff MFs, et al. High prevalence of sexually transmitted infections in HIV-infected men during routine outpatient visits in The Netherlands. Sex Trans Dis. 2012;39(1):8–15.CrossRef
36.
go back to reference Richel O, De Vries HJ, Dijkgraaf MG, Van Noesel CJ, Prins JM. Risk factors for the presence of anal intraepithelial neoplasia in HIV+ men who have sex with men. PLoS One. 2013;8(12):e84030.PubMedPubMedCentralCrossRef Richel O, De Vries HJ, Dijkgraaf MG, Van Noesel CJ, Prins JM. Risk factors for the presence of anal intraepithelial neoplasia in HIV+ men who have sex with men. PLoS One. 2013;8(12):e84030.PubMedPubMedCentralCrossRef
37.
go back to reference Galea JT, Kinsler JJ, Galan DB, et al. Factors associated with visible anogenital warts among HIV-uninfected Peruvian men who have sex with men and transwomen: a cross-sectional study. Sex Trans Dis. 2015;42(4):202–7.CrossRef Galea JT, Kinsler JJ, Galan DB, et al. Factors associated with visible anogenital warts among HIV-uninfected Peruvian men who have sex with men and transwomen: a cross-sectional study. Sex Trans Dis. 2015;42(4):202–7.CrossRef
Metadata
Title
Rectal Douching Prevalence and Practices Among Peruvian Men Who have Sex with Men and Transwomen: Implications for Rectal Microbicides
Authors
Jerome T. Galea
Janni J. Kinsler
Sarah McLean
Gino Calvo
Hugo Sánchez
Segundo R. Leon
Brandon Brown
Publication date
01-11-2016
Publisher
Springer US
Published in
AIDS and Behavior / Issue 11/2016
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-015-1221-9

Other articles of this Issue 11/2016

AIDS and Behavior 11/2016 Go to the issue