1. Health
Cory Silverberg

Understanding New Research on Lubricant Use During Anal Intercourse

By May 31, 2010

Follow me on:

Two studies about the safety of lubricant use during anal intercourse were presented last week at the 2010 International Microbicides Conference in Pittsburgh. The data from the studies has yet to be published, but there have already been several write-ups about the research , which at first blush seem to suggest that using lubricant might be found to be associated with an increased risk of STDs. As Jim Pickett, the chair of the International Rectal Microbicide Advocates (IRMA) one of the organizations involved in putting on the conference, said to me in an email, what is key is that this research be discussed and interpreted without hyperbole. If you're confused by what you've read so far, you're not alone. Let's start with the research itself.

One was a laboratory study of six popular lubricants used during anal intercourse. Actually only five of them are popular for anal intercourse (Astroglide, Elbow Grease, ID Glide, KY Jelly and Wet Platinum), the sixth (Pre) was used because it is isotonic (more on that below). The popular lubricants were chosen based on a large global survey which asked over 9,000 people about lubricant use during anal sex. Researchers did not report on which specific style of each product was used in the research, but in one write up I read that the "basic formulation" was used from each brand. (Interesting side note from my years in sex shops: the lubricant Pre is a lubricant made specifically for women trying to conceive. In addition to being isotonic, it is the only lubricant on the market that is specifically designed not to harm sperm).

The overall purpose of the study was to see if lubricant might play a role in increasing risk of STD transmission during anal intercourse. To this end, the researchers wanted to understand what, if any, direct damage lubricants might have on rectal and cervical tissue. They also wanted to see how the lubricants might impact healthy bacteria that are present in the rectum. There are, of course, many ways to damage rectal tissue. In this study the researchers focused on one particular effect which can damage the tissue in the rectum essentially by drying up cells, causing them to die and slough off. This can happen if the lubricant being used has higher concentrations of salts and sugars than are found in the skin cells it comes in contact with. The lubricant can draw water out of the cells, resulting in damage that can increase risk of infection (the science minded among you can find more detailed explanations here, here, or here).

They found that the four water based lubricants that had higher concentrations of salt (Astroglide, Elbow Grease, ID Glide, and K-Y Jelly) did in fact damage the outer layer of skin cells of the rectal and cervical tissue whereas the silicone lubricant and the water based Pre lubricant did not. In terms of how the lubricants impacted the healthy bacteria, they found that both Astroglide and KY Jelly had a negative effect (KY much worse than Astroglide) and that the other lubricants did not have a toxic effect.

A second study looked at the use of lubricants during anal intercourse outside the laboratory. This study included 229 men who had reported having receptive anal intercourse in the past month, and 192 women who reported having receptive anal intercourse in the past year. Participants completed a computer assisted self-interview about sexual behavior. Among other things, participants were asked about use (or non-use) of lubricants and the particular brands they used during anal sex. From that group, 302 participants also had rectal tests for chlamydia and gonorrhea. Most of the participants reported using lubricant the last time they had receptive anal intercourse. Of the 302 participants, 25 tested positive for an anal STD. More than two-thirds of the people diagnosed with an STD reported using lube the last time they had receptive anal intercourse, compared with one third of people who had not used a lube. Read another way, people who reported using lubricants the last time they had anal sex were about twice as likely to have chlamydia or gonorrhea as those who did not use lubricants.

Taken together, these two papers seem to be suggesting that using lubricants, or at least some kinds of lubricants, might actually be a bad idea when you're on the receiving end of anal intercourse. And if you listen to the press conference that followed the presentation of the data, it sounds like at least some of the researchers are comfortable interpreting this very early data with some significance.

But don't put away that lube bottle just yet (and probably you won't be putting it away ever). Remember that collecting data, interpreting it, and reporting on it are three very different activities. While some blog posts have suggested this is radical news, consider the fact that all of the reporting from the researchers themselves and from IRMA makes it clear that this is very preliminary research, and should be interpreted as such. It's actually the first research of it's kind, and it involved sample sizes too small to draw any significant conclusions from. It raises far more questions than it answers. Here are just a few:

The clinical study of people based on recall of past anal intercourse wasn't able to take into account which lubricants were used. Participants reported using many different kinds of lubricants across encounters, sometimes combining different lubricants in a given sexual encounter. If, as the laboratory study suggests, some lubes are better than others, we need to figure out which ones are better, and do they need to be used every time, in full concentration, to be "safer"?

Risk is never absolute and it never exists in a vacuum. The clinical study seems to suggest that using lubricant increases risk of getting an anal STD. But it doesn't consider the risk of infection without lubricant. Sex educators have said for years that lubricant makes anal sex safer because it reduces friction and tearing, and therefore reduces the risk of STD transmission. This new data doesn't contradict that because it doesn't address it. It's looking at only one aspect of safety, harm, and risk. It's useful data to have, to guide further research. But alone it isn't data that should guide practice, as it could just as easily be refuted in a replicated study or as we begin to take a broader research snapshot of lubricant use during anal sex.

Similarly, the lab study of lubricants, which does seem to draw conclusions that some lubricants may be "safer" than others, needs to be contextualized, lest we forget how slippery the term "safe" is. When a researcher says that a silicone lubricant was found to be safe, what they mean was that it didn't do the one or two bad things they were looking at. It doesn't mean that if you use silicone lubricant you will be safe, or even safer, if you don't also consider other factors.

As usual, sexual pleasure isn't being talked about at all, and this too needs to be addressed in both the conducting and reporting of future research. The end goal of all this research is awareness of risk and behavior change. We aren't talking about dental hygiene here. We are talking about activities people engage in for a reason, and sexual pleasure is often part of that reason. To talk about anal intercourse and lubricant, particularly to talk about lube as a risk factor, outside of the context of pleasure makes sense only in the lab, only in theory. It doesn't matter how good the research is, if you want to affect change in people's lives, you have to speak to us in a way that we can connect with. If the only argument you make for behavior change is numeric, it might scare us for about three minutes, but it's not likely to help us at all.

What's exciting about the IRMA is that they have brought together such a dynamic group of researchers, academics, activists, educators, and participants to work together on a problem much more complicated than any one group of us could ever tackle. They've got all the right people there. Unfortunately when only one aspect of the work gets the media spotlight, it's easy to push out the other, more complicated voices.

I'll give the final paraphrased word to Jim Pickett, IRMA chair, who in a press conference about the studies cautioned that IRMA doesn't want people to stop using lubricant, and they aren't suggesting that educators tell people not to use lubricant. He points out that even if these results are replicated, it doesn't mean that unprotected anal sex without lube will be better or safer. At this early research tells us for certain is, as they have been saying for many years, more research is needed on lubricants and anal intercourse, and the sooner we get it, the better equipped will be to make informed decisions about the kinds of risks we're willing to take and the extent to which we'll go to protect ourselves from STDs, including HIV.

Learn more:

| Twitter | Newsletter Signup | Sexuality Forum |

Comments
June 2, 2010 at 10:25 am
(1) chas. says:

So, bottom line, what is the best lube for anal sex?

June 2, 2010 at 2:02 pm
(2) Cory says:

Part of the bottom line of the post is that “best” depends on how you’re defining it. If by “best” you mean most comfortable, most practical given the way you’re playing, or something else related to the physical/psychological/emotional experience of anal sex, then there might be one group of lubricants that are “best” (based on those criteria, here’s a list of lubes often recommended for anal sex). But if by “best” you mean least likely to contribute to the transmission of an STD, this VERY preliminary research is suggesting you stick with either silicone lubricants or lubricants that are “isotonic” or “isomolar”. I know that isn’t a satisfying short answer, but it’s the best I can offer!

June 2, 2010 at 8:03 pm
(3) Desmond Ravenstone says:

Did any of these studies account for condom use?

June 2, 2010 at 11:01 pm
(4) dido says:

The word condom was not mentioned once in that whole summary….were these studies all of unprotected sex?!!!!!

June 3, 2010 at 11:26 am
(5) Cory says:

The studies haven’t been published, but I know I read that the results controlled for things like number of partners and number of times having anal intercourse, and they must have also controlled for condom use, meaning that the results, statistically speaking, were not due to some people using condoms and other people not using condoms.

Leave a Comment

Line and paragraph breaks are automatic. Some HTML allowed: <a href="" title="">, <b>, <i>, <strike>
Top Related Searches
  • intercourse
  • new research
    1. About.com
    2. Health
    3. Sexuality

    ©2014 About.com. All rights reserved.