Question

Which lube is best when using condoms to protect against HIV?

25 August 2011. Related: All topics, HIV transmission.

I would appreciate some advice on choosing a good lubricant.

I read somewhere that certain lubricants (eg KY) actually assist with the transmission of HIV in that they can actually melt condoms and that lubricants in actual fact aren’t advisable for this reason. That article also suggested that water based lubricants are better – is there one that you can recommend?

I have a new partner and would not want to put them in any danger where the condom’s efficacy is compromised by a lubricant.

Answer

Answer: Simon Collins

Thanks for your question which has an easy part and slightly more complicated second answer.

If you are using condoms then you need to use a water-based or silicone-based lubricant and not an oil-based lubricant. Oil-based lubricants are definitely out because they break down the rubber or latex.

Oil-based lubricants quickly weaken condoms so HIV can pass through. Often an oil-covered condom will split during sex, and the user may not realise it is burst or torn until after the event.

There are many different brands of lube, for example KY Jelly, ID Glide, Astroglide or Liquid Silk, which you can buy from a supermarket or chemist. Some lubes are also available free from your GUM clinic or GP. There are also different types, for example some lubes are designed specifically for vaginal and anal sex. Its up to you to try them all before you find one that suits you and your partner.

A slightly more complicated answer relates to some research last year that reported that nearly all lubricants, including water-based lubricants, damaged rectal tissue in test-tube studies. [1, 2] This was new and the damage may be important because another study reported higher STIs in people using lubricant compared to not using lubricants. [3] However, and this is important, if you are using condoms then any small cell damage caused but the lubricant will not increase the risk of HIV, because the condom will protect your partner from the HIV.

We don’t recommend one over another – so long as it is water or silicone-based you can experiment to find your preference.

References

Begay O et al. Identification of Personal Lubricants That Can Cause Rectal Epithelial Cell Damage and Enhance HIV Type 1 Replication in Vitro. AIDS Research and Human Retroviruses. Volume: 27 Issue 9: August 23, 2011. http://www.liebertonline.com/doi/abs/10.1089/AID.2010.0252.
Russo J et al. Safety and Anti-HIV Activity of Over-the-Counter Lubricant Gels. 2010 International Microbicides Conference, Pittsburgh, abstract 347, 2010. http://www.microbicides2010.org/files/LubesDezzuttiAbstract.pdf.
Gorbach PM et al. Rectal Lubricant Use and Risk for Rectal STI. 2010 International Microbicides Conference, Pittsburgh, abstract 348, 2010. http://www.microbicides2010.org/files/LubesGorbachAbstract.pdf.

2 comments

Simon Collins • 25 October 2011

Hi

Although the study is interesting, is is only one study, and the results seem to be specific for anal sex.

If you don’t have other partners, then your girlfriend will not be at any higher risk for these infections.

If you do have other partners, then continuing to use condoms and routine health check for other STIs will keep both of you healthy. How often you have a health check (ie every 3, 6, 12 months) will depend on how active your sex life is with other partners.
Mozydee • 22 October 2011

I am totally confused: if persons who used water-based lubricants reported a higher exposure to STIs than those that used unlubricated condoms, how can I protect my girlfriend against the same? Please help.