Rectal Douching Injury in Men Who Have Sex With Men

by Heather Boerner

PORTLAND, Oregon — Jamey Scott, RN, was meeting with a patient at the Ryan White clinic where she works in Richmond, Virginia, when he mentioned that he "douched" in preparation for sex.

The word stopped her, but Scott kept moving. Her training in HIV taught her that "you can't bat an eye" when patients say things that surprise you. But she did need to know more.

"I asked, 'Are you using like a Summer's Eve–type product or are you using a Fleet [enema]?" she said. "I just put it out there. If they're going to be bold enough to tell me, I'm going to be bold enough to ask."

According to data presented at the Association of Nurses in AIDS Care 2019 Conference, half the gay and bisexual black men in the Deep South have used an enema — or "rectal douche" as it's called in the community — although what they are using to douche is unclear.

For men who are receptive partners, it's even more common. This is despite the conventional wisdom that no one should regularly use an enema unless they have a neurologic condition, such as multiple sclerosis or spinal cord injuries, that necessitates it. Data also show that enemas, along with other sexual-hygiene practices, could increase the risk for HIV transmission and other sexually transmitted infections (STIs). But there are formulations that are safer, and research is ongoing into medicated formulations. Read more via Medscape