According to a study published in the journal Sexually Transmitted Infections, rectal douching might increase the odds of contracting HIV and other STIs — including hepatitis, chlamydia, and gonorrhea.
Researchers state that douching before sex can damage the lining of the rectum, which leads to an increased risk of transmission due to indirect entry into the bloodstream.
Rectal douching is a common practice among gay and bisexual men who prefer the “bottom” role in sex. It’s widely used in an effort cleanse the rectum before having anal sex. According to researchers, nearly half of men who have sex with men engage in the practice.
In this particular study, researchers examined 28 studies involving 21,570 MSM — 46 percent were in the U.S., 35 percent were in Europe, and the rest were in South America, Asia, and Africa, reports NAM AIDS Map. All of the studies were published between 1982 and 2018.
Twenty of the studies were particularly focused on the association between douching and HIV transmission. They found that men who practiced rectal douching were nearly three times as likely to contract HIV.
Fifteen of the studies focused specifically on the association between douching and other STIs. Researchers found that men were twice as likely to contract STIs like hepatitis B or C, as well as chlamydia and gonorrhea.
While authors note that it’s quite possible the risk of HIV and STIs might be greater because men who practiced douching were more likely to have anal sex without a condom, they still say it’s unlikely that’s the main cause for the higher percentage rate. They note that most of the studies performed “multiple analyses to take into account potential confounders such as sexual risk behavior and partner numbers.”
“More studies are needed to examine co-occurring high-risk sexual behaviors among MSM who practice rectal douching,” the authors concluded. “Our results suggest the need for health education materials that inform MSM about the potential increased risk of HIV/STIs if they choose to douche before or after anal sex.”