The Slippery Slope: Lubricant Use and Rectal Sexually

Published: December 19, 2011

Background: Use of lubricant products is extremely common during
receptive anal intercourse (RAI) yet has not been assessed as a risk
for acquisition of sexually transmitted infections (STIs).

Methods: Between 2006 and 2008, a rectal health and behavior
study was conducted in Baltimore and Los Angeles as part of the
University of California, Los Angeles Microbicide Development Program
(NIAID IPCP# #0606414). Participants completed questionnaires,
and rectal swabs were tested for Neisseria gonorrhoeae and
Chlamydia trachomatis with the Aptima Combo 2 assay, and blood was
tested for syphilis (for RPR and TPHA with titer) and HIV. Of those
reporting lubricant use and RAI, STI results were available for 380
participants. Univariate and multivariate regressions assessed associations
of lubricant use in the past month during RAI with prevalent STIs.

Results: Consistent lubricant use during RAI in the past month was
reported by 36% (137/380) of participants. Consistent past month
lubricant users had a higher prevalence of STI than inconsistent users
(9.5% vs. 2.9%; P ? 0.006). In a multivariable logistic regression
model, testing positive for STI was associated with consistent use of
lubricant during RAI in the past month (adjusted odds ratio: 2.98 95%
confidence interval: 1.09, 8.15) after controlling for age, gender, study
location, HIV status, and numbers of RAI partners in the past month.

Conclusions: Findings suggest some lubricant products may increase
vulnerability to STIs. Because of wide use of lubricants and their
potential as carrier vehicles for microbicides, further research is essential
to clarify if lubricant use poses a public health risk.

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