Lube & anal sex - does it increase the risk of infection?!

Two new studies were released at the 2010 International Microbicides Conference yesterday.



And the results of those studies were disturbing.



They found that people who used lube for anal intercourse were at greater risk of STI infection than those who did not. This was true even when other risk factors, including condom usage were controlled for.



WHAT?!!! This goes against everything my little safer sex heart has ever been told.



But if you drill down a little deeper, it starts to make sense.



You see, the one thing they didn't control for was what kind of lube was used.



So they did some tests with lube and cells in a lab. And, surprise, some lube is bad for ass cells.



They tested the six lubes most often used by the participants in the anal sex study (scroll to the end for ingredients lists):



Astroglide (they don't state which Astroglyde so I'm going to bet it was the glycerin version)


Elbow Grease (again - don't know what version)


ID Glide


KY Jelly


PRÉ (not used by the participants in the original study but chosen because it is different than the other lubes in a key way)


Wet Platinum (silicone - which also means it's glycerin free)



The studies found that when lube was used transmission of STIs doubled (11.7% of lube users were positive for an STI versus 4.5% of those not using lube). That's right. Double. (original study abstract, press release on original and follow up study abstract here) The STIs tested for were Chlamydia and Gonorrhea. No conclusions about HIV transmission was reached in this study.



What's also scary is that 24% of folks didn't use lube. And while they apparently were at less risk of STIs as a result, they were at increased risk of anal tearing and other unpleasant things.



So the folks who did the study did some more research. Lube smooths things out. It reduces tearing and abrasion. Why was it increasing transmission of disease? It didn't make sense. But when they started looking at the lubricant and how it acts on anal cells (vaginal and cervical cells were also included), things became more clear.

many of the products contain higher amounts of dissolved salts and sugars compared to what’s normally found in a cell. As a result, the products had toxic effects on the cells and rectal tissue studied. Some of the lubricants caused significant portions of the epithelium – the layer of cells that serves as a protective barrier inside the rectum – to be stripped away.*

So, it looked like it was possible that it was the composition of the lube that was the problem, not lube in general. What was the lube doing?



Astroglide, KY, Elbow Grease and ID Glide all resulted in cell death ( Astroglide was most toxic to cells and tissues). The cell death occured because these lubricants are hyperosmolar - they draw water out of cells which causes the cells to die.



For extra points, KY killed all of the bacteria it touched. Which is not good. Our anuses (anusi?) and vaginas have naturally occuring bacteria that keeps us healthy. Killing off all the bacteria can cause infection.



But PRE and Wet Platinum were not toxic and did not harm naturally occuring bacteria or cause cell death. Both of them were made of materials that are isomolar; they are made of stuff that doesn't draw water out of cells.



This study was done on cells in a lab. It doesn't prove that the same thing happens in the human body, but it does mean it's possible. Combined with the results of the study that found an increased risk of STIs with lube usage, it starts to appear that what kind of lube you use really matters.



What's the take home message?



Use better lube. Continue to use lube with anal intercourse and other sexual activities, but use high quality lube. Read the ingredients. Avoid lubes with glycerin and salt.



And stay tuned. I'm betting this study will be followed up with more. And we'll finally get good information about how lube acts on our bodies. Which is good news. Because an informed consumer is a healthy and happy consumer.



Ingredients

Astroglyde ingredients
Purified Water, Glycerin, Propylene Glycol, Polyquaternium 15, Methylparaben, Propylparaben



Elbow Grease Original Ingredients
Acid, Di Water, Mineral Oil, Petrolatum, Paraffin, Peg-8, Sorbitan Stearate, Polysorbate-60, Stearic Stearyl Alcohol (and) Ceteareth-20, Cetyl Alcohol, Lanolin, Borax, Methylparaben, Propylparaben, Imidazolidinyl Urea.



Elbow Grease Gel Ingredients
DI Water, Glycerin, Glycereth-26, Hydroxyethylecellulose, Methylparaben, Propylparaben, Imidazolidinyl Urea



ID Glyde
Urea, Purified Water, Glycerin, Propylene Glycol, Cellulose Polymer, Polyethylene Oxide, Sodium Benzoate, Methyl Paraben, Carbomer 981, Tetrahydroxypropyl Ethylenediamine, DiazolidinylEDTA



KY Jelly
Chlorhexidine Gluconate, Glucono Delta Lactone, Glycerin, Hydroxyethylcellulose, Methylparaben, Purified Water, Sodium Hydroxide



PRÉ ingredients
Purified Water, Hydroxyethylcellulose, Pluronic, Sodium Chloride, Sodium Phosphate, Carbomer, Methylparaben, Sodium Hydroxide, Arabinogalactan, Potassium Phosphate, Propylparaben.



Wet Platinum ingredients
Dimethicone, Cyclomethicone, Dimethiconol



*Use of Lubricants, Unprotected Anal Sex and the Risk of HIV, Press Briefing, 2010 Microbicides: Building Bridges in HIV Prevention