Rectal douching among men who have sex with men in six cities in China: a cross-sectional study
Peiyang Li A , Tanwei Yuan B , Zhenyu Wang A , Ruonan Huang A , Xiaojun Meng C , Kechun Zhang D , Guanghui Wang E , Yepeng Zhou F , Danyang Luo G , Ying Wang H , Yong Cai H and Huachun Zou
B I J
+ Author Affiliations
- Author Affiliations
A School of Public Health, Sun Yat-sen University, Guangzhou 510080, PR China.
B School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 510006, PR China.
C Wuxi Municipal Center for Disease Control and Prevention, Wuxi 214000, PR China.
D Shenzhen Longhua District Center for Disease Control and Prevention, Shenzhen 518000, PR China.
E Qingdao Qingtong AIDS Prevention Volunteer Service Center, Qingdao 266000, PR China.
F Foshan Friends Care Center for AIDS/HIV Control, Foshan 528000, PR China.
G Zhitong Guangzhou LGBT Center, Guangzhou 510000, PR China.
H School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, PR China.
I Kirby Institute, UNSW Sydney, Sydney, NSW 2052, Australia.
J Corresponding author. Email: zouhuachun@mail.sysu.edu.cn
Sexual Health 17(5) 437-443 https://doi.org/10.1071/SH19239
Submitted: 28 December 2019 Accepted: 28 July 2020 Published: 13 November 2020
Abstract
Background: Rectal douching, which is a common practice among men who have sex men (MSM) as a preparation for anal sex, may potentially increase the risk of HIV infection. However, little is known about the practice of rectal douching among Chinese MSM. This study investigated the characteristics of rectal douching and factors associated with rectal douching. Methods: Between January and March 2019, MSM aged ≥18 years in six cities in China were recruited to the study. Participants were asked to complete a self-administered online questionnaire. Chi-squared tests and multivariable logistic regression were used to examine factors associated with rectal douching by calculating odds ratios (ORs) and 95% confidence intervals (CIs). Results: Of 485 MSM in this study, 278 (57.3%) practiced rectal douching in the preceding 6 months. The most common reasons for douching before and after anal sex were hygiene/cleanliness (78.6% and 66.1% respectively) and HIV/STI prevention (8.5% and 17.4% respectively). The most used enemas and equipment before and after anal sex were tap water (73.5% and 70.2% respectively) and showerhead hoses (76.1% and 75.2% respectively). Men who engaged in both insertive and receptive anal sex (OR 8.84; 95% CI 4.52–17.30), exclusively receptive anal sex (OR 6.56; 95% CI 3.55–12.13), condom-less anal intercourse (OR 1.64; 95% CI 1.03–2.63) and anal sex after alcohol use (OR 1.54; 95% CI 1.00–2.35) were more likely to perform douching. Conclusion: Rectal douching is common in MSM, some of whom may not realise the potential risks associated with douching. The co-occurrence of douching and other high-risk behaviours would make MSM more vulnerable to HIV. Health education aimed at informing MSM of the potential risks and addressing the high prevalence of douching are urgently needed.
Keywords: HIV, HIV/AIDS, risk behaviours.
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