Nā ʻike nui
(1) ʻO ka hoʻohana ʻana o ka gastrointestinal tract e like me ke ʻano pili o ka iwi pili me nā pilikia olakino o kahi ʻano infectious a traumatic.
(2) Ma waena o nā poʻe e alakaʻi ana i kahi ke ʻano homose wahine, ʻo nā kāne a me nā wahine, ua nui ka nui o nā pilikia o nā maʻi like ʻole, nā maʻi ʻeha (HIV, syphilis, gonorrhea, etc.), a me nā mea hoʻokūkū a me nā psychiatric.