New research presented at the Microbicides 2010 conference, as reported in Medscape, indicates that several common over-the-counter sexual lubricants can damage rectal and vaginal tissue, thereby increasing vulnerability to a number of sexually transmitted infections (STIs), including chlamydia, gonorrhea and HIV. These results build on previous studies with similar findings [1-2].
Rectal lubricant gels are widely used , but the evidence is now pretty convincing that the hyperosmolar kind (those with a higher concentration of salts and sugars relative to epithelial cells with which they come into contact) can cause significant damage to sensitive tissue and greatly increase the danger of infection. There has also been some research on the common use of saliva as a sexual lubricant, especially among men who have sex with men , but more studies are required to determine whether saliva use in this way contributes to transmission of saliva-borne pathogens.
According to a press release from the Microbicides 2010 conference, in the United States alone receptive anal intercourse is practised by 90 percent of gay and other men who have sex with men. Moreover, the practice is not limited to men. U.S. estimates and surveys in the United Kingdom indicate between 10 to 35 percent of heterosexual women have engaged in anal sex at least once. Globally, estimates suggest 5 to 10 percent of sexually active women are having anal sex. Despite enormous efforts to promote condom use, especially in the past quarter century, most acts of anal sex go unprotected.
All this begs the big condom question. Although the recent research on lubricants is troubling enough, it should not distract public health authorities and community-based organizations from emphasizing yet again the plain fact that consistent condom use is the best way to prevent STIs [5-6].
1. Fuchs EJ, Lee LA, Torbenson MS, Parsons TL, Bakshi RP, Guidos AM, Wahl RL, Hendrix CW. Hyperosmolar sexual lubricant causes epithelial damage in the distal colon: potential implication for HIV transmission. J Infect Dis. 2007 Mar 1;195(5):703-10. Epub 2007 Jan 23. PubMed PMID: 17262713.
2. Sudol KM, Phillips DM. Relative safety of sexual lubricants for rectal intercourse. Sex Transm Dis. 2004 Jun;31(6):346-9. PubMed PMID: 15167643.
3. Javanbakht M, Murphy R, Gorbach P, Leblanc MA, Pickett J. Preference and practices relating to lubricant use during anal intercourse: implications for rectal microbicides. Sex Health. 2010 Jun;7(2):193-8. PubMed PMID: 20465986.
4. Butler LM, Osmond DH, Jones AG, Martin JN. Use of saliva as a lubricant in anal sexual practices among homosexual men. J Acquir Immune Defic Syndr. 2009 Feb 1;50(2):162-7. PubMed PMID: 19131893.
5. Weller S, Davis K. Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst Rev. 2002;(1):CD003255. PubMed PMID: 11869658.
6. Mindel A, Sawleshwarkar S. Condoms for sexually transmissible infection prevention: politics versus science. Sex Health. 2008 Mar;5(1):1-8. PubMed PMID: 18361848.
cc flicker photo by Erik Pronske