Men who have sex with men (MSM) and who practice rectal douching before receptive anal intercourse have a higher risk of HIV and other sexually transmitted infections (STIs), including hepatitis B and C viruses (HBV and HCV), aidsmap reports.
Publishing their findings in Sexually Transmitted Diseases, researchers conducted the first meta-analysis and systematic review to assess the HIV- and STI-related risks associated with rectal douching among MSM. They included 28 studies published between 1982 and 2018 that included a total of 21,570 MSM participants. Forty-six percent of the studies were conducted in the United States, 35% were from Europe and the remainder were from South America, Asia and Africa.
Fifty-two percent of the participants reported rectal douching. Of that group, 52% reported recent condomless intercourse, and 58% reported a high number of recent sex partners.
The meta-analysis included 24 studies with a total of 20,398 participants. Men in these studies who reported rectal douching, compared with those who did not, had a 2.8-fold higher risk of HIV. After an adjustment for other factors that may have influenced this association, this figure was reduced only slightly, to a 2.74-fold increased risk.
The 15 studies that provided data about the link between rectal douching and other STIs indicated that the practice was associated with a 2.46-fold increased risk of such a diagnosis. In particular, rectal douching was tied to a threefold higher risk of HBV, HCV, chlamydia and gonorrhea. After an adjustment for factors that may have influenced the association between douching and all non-HIV STIs, the figure was reduced to a 2.27-fold increased risk.
Rectal douching may influence the risk of contracting HIV and other STIs by damaging the delicate rectal lining, flushing out protective bacteria in the rectum and transmitting infections through shared rectal douching tools.
The study authors stressed that long-term studies are needed to further explore the association between rectal douching and HIV and other STIs.
To read the aidsmap article, click here.
To read the study abstract, click here.