Rectal douching among Peruvian men who have sex with men, and acceptability of a douche-formulated rectal microbicide to prevent HIV infection

Abstract Background: Rectal douching (RD) is widely practiced by men who have sex with men (MSM), and is correlated with increased risk of HIV infection. However, the mechanism of how RD increases the risk of HIV infection is not well understood, and there is limited data on RD behavior in MSM practicing anal sex in China. We examine the purpose of RD, its timing in relation to anal sex, the types of RD products used, and risky sexual behaviors among MSM reporting anal sex.Methods: Between August 2017 and December 2018, a cross-sectional study was conducted among adult MSM in Shenyang, China. Data were collected on demographics, sexual behaviors, and RD for the most recent sexual intercourse by means of interviewer-administered face-to-face questionnaires. Blood samples were collected to test for antibodies to HIV and syphilis. Multivariable logistic regression models were used to assess the risk factors associated with HIV infection.Results: A total of 515 eligible MSM participated in this survey (median age: 31 years). During the most recent anal intercourse, 28.3% (146/515) had condomless receptive anal intercourse (CRAI), 21.4% (110/515) practiced serosorting, and more than half (61.6%, 317/515) reported RD before or after anal sex. Of those practicing RD, 96.8% (307/317) conducted RD before sex, while 62.5% (198/317) conducted RD after sex. The douching devices used were primarily shower hoses (85.3%, 262/307), and relatively few MSM used commercial RD products (8.1%). The prevalence of HIV-1 and syphilis was 11.7% and 13.2%, respectively. HIV infection was positively associated with RD (adjusted odds ratio (AOR), 2.8; 95% confidence interval (CI), 1.4-5.5), practicing RD before sex (AOR, 2.3; 95% CI, 1.2–4.3), practicing RD after sex (AOR, 1.8; 95% CI, 1.0–3.1), using a shower hose for RD (AOR, 3.5; 95% CI, 1.1–13.0), condomless receptive anal intercourse (CRAI) (AOR, 2.9; 95% CI, 1.6–5.5), and using nitrite inhalants (AOR, 2.8; 95 % CI, 1.6-5.1) in the most recent anal intercourse.Conclusions: RD is popular among Chinese MSM. Improper noncommercial RD tools increase the rates of HIV infection. Public health workers and the MSM community should publicize scientific knowledge and prevention approaches relating to RD and HIV transmission to MSM, and we recommend that better tools be offered to assist in RD in order to decrease the risk of acquiring HIV.

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Faculty Opinions recommendation of Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717954094.793459876 ◽

2012 ◽

Author(s):

Joe Eron ◽

Christopher Hurt

Keyword(s):

Hiv Infection ◽

Meta Analysis ◽

Sex With Men

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Love and Intimacy as Vulnerability to HIV Infection: A Case Study of MSM

Social Work Chronicle ◽

10.21863/swc/2016.5.1.007 ◽

2016 ◽

Vol 5 (1) ◽

Author(s):

Archana Kaushik

Keyword(s):

Hiv Infection ◽

Cultural Values ◽

Sexual Behaviors ◽

Sex Workers ◽

Sexual Minorities ◽

Suicide Attempts ◽

Service Providers ◽

Structural Barriers ◽

Health Seeking ◽

Sex With Men

Sexual minorities are among the most marginalized groups in the society. Sero-positivity accentuates social exclusion among the sexual minorities. The paper aims to appraise the factors that make Men who have Sex with Men (MSM) vulnerable to HIV infection and influence their health seeking behaviors. It highlights two major domains socio-cultural and interpersonal variables. Qualitative in nature and based on ten in-depth case studies of HIV infected MSM, the study is located in Delhi, India. Factors such as age, marital status, child sexual abuse, multiple sex partners, are crucial in influencing their vulnerability. Socio-cultural milieu puts structural barriers restricting integration of MSM in the society. Cultural values do not allow talking about sex, which hampers healthy sexual behaviors. Exhibiting aggression, sexual violence, visiting sex-workers etc. are considered as important aspects to prove manhood. At the interpersonal level, possessiveness, betrayal, infidelity, heartbreak, strong emotional whirlpool when love-relations go incongruent, all takes a heavy toll of their mental and physical health. These variables socially exclude the sexual minorities from the mainstream life. Findings show positive (disclosing to family, abstinence, spiritual growth) and negative (suicide-attempts, drug-use) ways of coping among the MSM respondents. Critical areas of concern for service-providers while planning interventions for empowering people with sexual minority are delineated.

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Use of multiple recreational drugs is associated with new HIV infections among men who have sex with men in China: a multicenter cross-sectional survey

BMC Public Health ◽

10.1186/s12889-021-10223-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiang Mao ◽

Sequoia I. Leuba ◽

Qinghai Hu ◽

Hongjing Yan ◽

Zhe Wang ◽

...

Keyword(s):

High Risk ◽

Hiv Infection ◽

Risk Behaviors ◽

Sexual Behaviors ◽

Hiv Infections ◽

Recreational Drugs ◽

Limited Information ◽

High Risk Behaviors ◽

Sex With Men ◽

Recent Hiv Infection

Abstract Background There is limited information about the types of recreational drugs used by men who have sex with men (MSM) in China or the consequent impact on sexual health and human immunodeficiency virus (HIV) acquisition. Methods We recruited MSM from seven cities in China between 2012 and 2013 using multiple approaches including advertisements on gay websites, collaborating with local MSM community-based organizations, peer referrals, and venues such as gay bars and bathrooms visited by MSM. We divided participants into four subgroups based on the number of recreational drugs (RDs) used in the previous 6 months. We defined use of multiple RDs as use of ≥2 types of RDs. Demographics and HIV-related high-risk behaviors were collected, and blood samples were tested for recent HIV infection by the HIV-1 subtypes B, E, and D immunoglobulin G capture enzyme immunoassay (BED-CEIA). We used multivariable logistic regression adjusted for sociodemographics to determine the adjusted odds ratios (aORs) and associated 95% confidence intervals (CIs) of the subgroups of RD use for recent or established HIV infection. Results A total of 4496 Chinese MSM participated; 28.4% used RDs, and 5% used multiple types of RDs. The prevalence of each RD use was as follows: poppers (25.9%), ecstasy (2.4%), ketamine (1.2%), amphetamine (0.6%), tramadol (0.4%), methamphetamine (3.8%), and codeine (1.9%). Users of multiple RDs commonly used poppers combined with one or more other types of RDs. Multiple RD users were likely to be aged 26–30 years (vs. 18–25 and > 30 years), live in non-local cities (vs. local cities), never married (vs. married), have a high monthly income (vs. no income and 1–599 USD), use versatile positions during anal intercourse (vs. top or bottom), and have inadequate HIV-related prevention knowledge (vs. adequate). As the number of RDs used in the previous 6 months increased, the prevalence of HIV-related high-risk behaviors increased (P < 0.05 for all). The odds of recent HIV infection were higher among those who used one type (aOR = 2.2, 95% CI: 1.5–3.0) or two types of RD (aOR=2.3, 95% CI: 1.0-5.2) in the previous 6 months compared to the odds among those who did not use RDs. Conclusion The level and pattern of multiple RD use among Chinese MSM were different from high-income countries. MSM who used more RDs are more likely to engage in high-risk sexual behaviors, and these behaviors may be associated with increases in new HIV infections.

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Time trends in the risk of HIV infection among men who have sex with men in Chiang Mai, Thailand: an observational study

International Journal of STD & AIDS ◽

10.1177/09564624211021338 ◽

2021 ◽

pp. 095646242110213

Author(s):

Amaraporn Rerkasem ◽

Nuntisa Chotirosniramit ◽

Pongpun Saokhieo ◽

Antika Wongthanee ◽

Kittipan Rerkasem

Keyword(s):

Hiv Infection ◽

Hiv Testing ◽

Consistent Condom ◽

Anal Sex ◽

Health Seeking ◽

Chiang Mai ◽

Transmitted Infection ◽

Significant Difference ◽

Receptive Anal Sex ◽

Sex With Men

A cross-sectional study on men who have sex with men (MSM) for the HIV prevention project was conducted to assess the prevalence of HIV infection–related behaviors among 551 MSM recruited in 2008–2009 and 1910 MSM in 2014–2018 for voluntary counseling and testing at a HIV clinic in Chiang Mai. Overall, the study found that the prevalence of HIV infection was significantly decreased from 12.9% (71/551) in the earlier study (2008–2009) to 8.2% (157/1910) in the recent study (2014–2018) ( p = 0.001). By comparison, in 2008–2009 and 2014–2018, there was no statistically significant difference in consistent condom use (39.0% [186/477] vs. 38.9% [591/1512], p = 0.969), while unprotected anal sex with casual partners significantly increased (44.5% [159/357] vs. 51.9% [645/1242], p = 0.014) and receptive anal sex significantly increased (37.7% [180/477] vs. 45.1% [860/1905], p = 0.004). However, previous HIV testing within 1 year increased significantly from 64.6% (197/305) to 74.7% (677/906, p = 0.001). In exploratory multivariate analysis, the factors associated with HIV infection included gay men, age below 20 years, being self-employed, being an employee, having only receptive anal sex, having both receptive/insertive anal sex, being a former substance user, using online dating, having a history of sexually transmitted infection symptoms, self-perception as being at high risk for HIV, last HIV testing >1 year, and never previously testing for HIV. The data represent the trend of health-seeking behavior improvements. The findings demonstrated the need for a novel sexual health service in an endemic setting and health promotion for online partner-seeking.

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