Official websites use. Share sensitive information only on official, secure websites. Corresponding author: Jerome T. While gel-formulated Rectal Microbicides RM are the first to enter clinical trials, rectal douching in preparation for anal intercourse is a common practise, thus RMs formulated as douches may be a convenient alternative to gels.
This qualitative study examined thoughts regarding douches, their use as a RM and current douching practises among men who have sex with men and transgender women. Focus groups and interviews were recorded, transcribed verbatim and coded; text relating to rectal douching was extracted and analysed.
Sociodemographic information was collected using a self-administered questionnaire. Support for a douche-formulated RM centred on the possibility of combined pre-coital hygiene and HIV protection, and it was believed that a deeply-penetrating liquid douche would confer greater HIV protection than a gel.
Drawbacks included rectal dryness; impracticality and portability issues; and, potential side effects. Non-commercial douching apparatus use was common and liquids used included detergents, vinegar, bleach, lemon juice and alcohol. A douche-formulated RM while desirable and perceived as more effective than a gel-formulated RM also generated questions regarding practicality and side-effects.
Of immediate concern were the non-commercial liquids already being used which likely damage rectal epithelia, potentially increasing HIV infection risk. Pre-coital rectal douching is common and a RM formulated as such is desirable, but education on rectal douching practices is needed now. Despite a worldwide decrease in new HIV infections, 1 the epidemic continues to expand in men who have sex with men MSM and transgender women TGW 2 whose primary risk of infection is unprotected receptive anal intercourse.
