Preference and practices relating to lubricant use during anal intercourse: Implications for rectal microbicides

School of Public Health, Department of Epidemiology, University of California, Los Angeles, Box 957353, 10880 Wilshire Boulevard, Suite 1800, Los Angeles, CA 90095-7353, USA.
Sexual Health (Impact Factor: 1.37). 06/2010; 7(2):193-8. DOI: 10.1071/SH09062
Source: PubMed


The importance of the acceptability of rectal microbicides for HIV and sexually transmissible infections (STIs) prevention is widely recognised. Given relatively consistent use of lubricants for anal intercourse (AI) and the potential for lubricant-like rectal microbicides, understanding barriers to lubricant use may help inform hurdles likely to be encountered once a rectal microbicide becomes available.
We conducted an internet-based survey using a 25-item questionnaire to assess AI and lubricant use, including lubricant preferences and barriers to use.
The majority of the 6124 respondents who reported AI were male (93%), 25 years or older (80%) and from North America (70%). Consistent condom use during AI was reported by a minority (35%) and consistent lubricant use was reported by over half of respondents. Reasons for non-use differed by age and region. Among men, those <25 years were more likely to report barriers around cost compared with those 45 and older (odds ratio (OR) = 6.64; 95% confidence interval (CI) 3.14-14.03). European men (OR = 1.92; 95% CI 1.50-2.45), Latin American women (OR = 3.69; 95% CI 1.27-10.75) and Asian women (OR = 4.04; 95% CI 1.39-11.78) were more likely to report sexual preference as a reason for non-use.
Rectal lubricants are widely used, but barriers to use vary by age and region for dry sex. A lubricant-like rectal microbicide would potentially be acceptable and such a product may be useful as a method of HIV prevention. However, targeted marketing and educational approaches may be needed to enhance use and acceptability of such a product.

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    • "Our finding that douching varied by region is supported by the small number of rectal douching prevalence studies [18,22,23] as well as other studies on rectal practices surrounding AI such as lubricant use [30] and may reflect variations in sexual practices by region. Indeed, in exploring reasons for lack of rectal douching by region we found that in regions where the prevalence of rectal douching was low such as Asia, reporting that ‘Didn’t know people used an enema or douche for anal intercourse’ was far more common than regions where rectal douching was high (53% in Asia vs. 17% in North America, p value < .01; data not shown). "
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