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Abstract INTRODUCTION: It has been documented that the majority of men who have sex with men (MSM) use lubricants during rectal intercourse. Many OTC sexual lubricants contain N-9. A number of animal and human studies have presented evidence that lubricants containing N-9 damage the delicate rectal epithelium and in this way increase the vulnerability to infection by HIV and other sexually transmitted pathogens. These observations prompted CDC, WHO, and CONRAD to recommend that N-9 products should not be used rectally. This raises the question of which products are safe to use? We have previously assayed four lubricants and ranked them in terms of rectal safety. In the present study, 13 additional OTC lubricants have been evaluated. METHODS: Products assayed were Forplay Gel-PLUS, Liquid Silk, Maximus, Wet Classic, Wet Platinum, Elbow Grease Light Gel, Eros Bodyglide, Probe Thick Rich, Slippery Stuff, Toys in Babeland, KY Jelly, O’My Natural. A methylcellulose formulation, and PBS were used as the control. Lubricants were assayed for cytotoxicity using the MTT assay. The effect of lubricants on preventing or enhancing infection was studied using rectal challenge by HSV-2 in mice. The effect on sloughing of epithelial cells of the rectum was assayed using a non-labor-intensive mouse system. RESULTS: Unfortunately none of the products tested proved to be safer or more protective than the controls. Overall the safest lubricants were found to be Toys in Babeland, Elbow Grease, Slippery Stuff, and O’My. The least safe were Probe, Anal Lube, and Forplay Gel-PLUS. Results for Maximus showed that although it did not cause significant sloughing of rectal epithelial cells, it did enhance rectal infection by HSV-2 more than any of the other products. CONCLUSION: Significant differences were observed among the products. As manufacturers do not divulge the components of these products it is difficult to determine what accounts for the differences observed. However, the observations enable us to surmise which lubricants are likely to be the safest for use during rectal sex. FDA and other regulatory agencies do not regulate lubricants as strictly as pharmaceuticals. Because some of these products may enhance infection during rectal intercourse, sexual lubricants should be more stringently regulated. Poster Session
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