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. 2019 Jun;23(6):1484-1493.
doi: 10.1007/s10461-018-2336-6.

Rectal Douching Practices Associated with Anal Intercourse: Implications for the Development of a Behaviorally Congruent HIV-Prevention Rectal Microbicide Douche

Alex Carballo-Dieguez  1 , Rebecca Giguere  2 , Cody Lentz  1 , Curtis Dolezal  1 , Edward J Fuchs  3 , Craig W Hendrix  3
Affiliations

Rectal Douching Practices Associated with Anal Intercourse: Implications for the Development of a Behaviorally Congruent HIV-Prevention Rectal Microbicide Douche

Alex Carballo-Dieguez et al. AIDS Behav. 2019 Jun.

Abstract
in English, Spanish

Tenofovir administration via rectal douching results in higher rectal-mucosa drug concentration than oral administration. Many who engage in receptive anal intercourse (RAI) use cleansing rectal douches. To inform development of a behaviorally-congruent tenofovir douche, 4751 individuals ≥ 18 years-old, born male, from all US states/territories, who engaged in anal intercourse responded to an online survey. Of those who reported RAI in the prior 3 months, 80% douched beforehand, 82% within 1 h, mean 2.9 consecutive applications; 27% douched afterwards, 83% within 1 h, mean 1.7 consecutive applications. Among multidose users, 78% applied doses within 2 min, and 76% retained liquid < 1 min. Most used tap water (89%) in an enema bottle (50%) or rubber bulb (43%), and douched for cleanliness (97%), to avoid smelling bad (65%), and to enhance pleasure (24%). 98% reported high likelihood of using an HIV-prevention douche. An ideal product will protect within a user's typical number of applications, within 1 h, and be dissolvable in tap water.

La administración de tenofovir por medio de una ducha rectal resulta en una concentración de droga en la mucosa rectal más alta que por vía oral. Muchos de los que tienen sexo anal receptivo (SAR) usan duchas rectales para limpiarse. Para informar el desarrollo de una ducha rectal congruente con los comportamientos habituales de los usuarios, 4,751 individuos mayores de 18 años, nacidos varones, de todos los estados y territorios de los EEUU, que tenían sexo anal respondieron a una encuesta por Internet. De los que reportaron SAR en los últimos 3 meses, 80% usaron una ducha previamente, 82% dentro de una hora, con un promedio de 2.9 aplicaciones consecutivas; 27% usaron una ducha posteriormente, 83% dentro de una hora, con un promedio de 1.7 aplicaciones consecutivas. De los que usaron múltiples dosis, 78% aplicaron las dosis dentro de 2 minutos, y 76% retuvieron el líquido < 1 minuto. La mayoría usó agua corriente (89%) en una botella de enema (50%) o un bulbo de goma (43%), y se ducharon para estar limpios (97%), para evitar feos olores (65%), y para aumentar el placer (24%). 98% reportó alta probabilidad de usar una ducha que prevenga el VIH. El producto ideal debería proteger dentro del número típico de aplicaciones del usuario, dentro de una hora, y ser soluble en agua corriente.

Keywords: Enemas; HIV-prevention; Rectal douching; Rectal microbicides.

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Conflict of interest statement

Conflicts of Interest: None to declare

Figures

Fig. 1.
Fig. 1.
Survey advertisement sent to inbox of all Grindr users in US and its territories
Fig 2.
Fig 2.
Subsamples of participants answering different survey questions
See this image and copyright information in PMC

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