Prevalence and types of rectal douches used for anal intercourse: results from an international survey.

BackgroundRectal products used with anal intercourse (AI) may facilitate transmission of STIs/HIV. However, there is limited data on rectal douching behavior in populations practicing AI. We examined the content, types of products, rectal douching practices and risk behaviors among those reporting AI.MethodsFrom August 2011 to May 2012, 1,725 women and men reporting receptive AI in the past 3 months completed an internet-based survey on rectal douching practices. The survey was available in English, French, German, Mandarin, Portuguese, Russian, Spanish, and Thai and included questions on sexual behaviors associated with AI including rectal douching. Differences by rectal douching practices were evaluated using chi-square methods and associations between reported douching practices and other factors including age and reported STI history were evaluated using logistic regression analysis.ResultsRespondents represented 112 countries, were mostly male (88%), and from North America (55%) or Europe (22%). Among the 1,339 respondents (66%) who reported rectal douching, most (83%) reported always/almost always douching before receptive AI. The majority of rectal douchers reported using non-commercial/homemade products (93%), with water being the most commonly used product (82%). Commercial products were used by 31%, with the most common product being saline-based (56%). Rectal douching varied by demographic and risk behaviors. The prevalence of rectal douching was higher among men (70% vs. 32%; p-value < .01), those reporting substance-use with sex (74% vs. 46%; p-value < .01), and those reporting an STI in the past year (69% vs. 57% p-value < .01) or ever testing HIV-positive (72% vs. 53%; p-value < .01). In multivariable analysis, adjusting for age, gender, region, condom and lubricant use, substance use, and HIV-status, douchers had a 74% increased odds of reporting STI in the past year as compared to non-douchers [adjusted odds ratio (AOR) = 1.74; 95% CI 1.01-3.00].ConclusionGiven that rectal douching before receptive AI is common and because rectal douching was associated with other sexual risk behaviors the contribution of this practice to the transmission and acquisition of STIs including HIV may be important

Modulation of Variation by Response-Reward Spatial Proximity

There has been a recent surge in the experimental investigation of the control of behavioral variability. Currently, it is understood that variability in behavior is predictably modulated by reinforcement parameters (e.g., a probability of reward delivery and reward magnitude). In two experiments, we investigated how spatial proximity between response and reward locations impacts the production of behavioral variability in both response rate and lever press duration. Rats were trained to lever press on two levers in a standard operant chamber that only differed from one another in their proximity to a food niche (i.e., Near vs. Far); a second experimental factor, the probability of reward, was signaled by an auditory cue. In Experiment 1, trials with a high-probability stimulus terminated with reward on 100% of trials, while trials with a low-probability stimulus terminated with reward 25% of the time. We used a similar procedure in Experiment 2, but reduced the likelihood of reward on low-probability trials to 10% and collected data in a post-acquisition extinction test. Overall, proximity and probability were inversely related to variation of response rate, whereas only the probability factor affected variation in lever press duration. Proximity also interacted with probability to influence variation in response rate. These findings extend the factors modulating behavioral variability to include the spatial proximity between a response and reward