Project

Determining the Safety of Sexual Lubricants

Research conducted by Population Council scientists resulted in a better understanding of the relative safety of personal lubricants used during sexual intercourse.

The Issue

For decades, it has been understood that water-based lubricants, when used in combination with condoms, reduce the risk of sexually transmitted infections (STIs), including HIV. Evidence indicates that such lubricants reduce friction, which lowers the risk of tears in condoms and in delicate vaginal and rectal tissue—thus reducing the transmission of STIs.

However, in 2000, Population Council research found that water-based lubricants containing nonoxynol-9, a commonly used spermicide, could actually increase the risk of HIV and STI infection. Findings suggested that nonoxynol-9 damaged rectal tissue, which could increase the risk of skin tears, providing a pathway for HIV infection. Findings also suggested that nonoxynol-9 could increase the probability of herpes simplex virus infection.

Concerned that other water-based lubricants might also not be as safe as previously believed, in 2011 Council researchers undertook studies to determine which lubricants could be safely recommended for use in HIV prevention.

The Progress

Council researchers tested more than 40 water-based lubricants, the majority of which had been identified as popular anal lubricants in a survey conducted by the International Rectal Microbicide Advocates.

The studies, conducted on tissue samples in a lab, showed that the majority of the tested lubricants enhanced the replication of HIV and damaged rectal tissue, increasing the risk of HIV transmission. The findings also suggested that an entire class of compounds frequently used in lubricants, called polyquaterniums, might increase HIV risk.

While the findings raise serious concerns, further investigation is needed before researchers can reach a definitive conclusion regarding the safety of water-based lubricants.

The Impact

In 2007, Council findings prompted the US Food and Drug Administration to require that all contraceptive/spermicidal products containing nonoxynol-9 bear a warning against use in anal intercourse. In 2012, the World Health Organization, the United Nations Population Fund, and FHI 360 cited Council findings in an advisory note calling for procurement agencies to avoid lubricants containing high levels of glycols (like nonoxynol-9) and polyquaterniums. While further study is needed, understanding the possible risks associated with sexual and reproductive health commodities is essential in developing effective HIV prevention initiatives.

The Population Council continues to work with other leaders in the field, in particular the International Rectal Microbicide Advocates and the US Centers for Disease Control and Prevention, to call for further investigation into the safety of personal lubricants, the effects of their repeated use, and their potential impact on the transmission of HIV and other STIs.

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