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The potential of lubricant in HIV prevention

Friday, 22 March, 2013

Little is known about the impact of lubricant on reducing the risk of HIV transmission and the demand for it remains ‘largely misunderstood’. However, preliminary research indicates that when combined with condoms, lubricant has the potential to decrease the risk of HIV transmission as condoms are less likely to break during sex. At-risk groups that have the greatest need for lubricant, namely men who have sex with men (MSM) and sex workers, often resort to using products such as butter and petroleum jelly, where lubricant is not available. However, unlike water- and silicon-based lubricants, which are much more condom friendly, oil-based products are harmful to condoms and increase the risk of them breaking.

Globally, lubricant is much less readily available than condoms. The Global Forum on MSM and HIV (MSMGF) conducted a survey last year, which revealed that less than a quarter of the 5,000 MSM from across 165 countries surveyed had easy access to free lubricant. Although condoms have been promoted as a key component of HIV prevention for some time, it is only in recent years that we have seen a focus on the importance of lubricant. The US government’s aid programme (USAID), for example, began supporting condom distribution in the 1970s, while lubricant has only been distributed by USAID since 2008. The United Nations Population Fund (UNFPA) took the decision to add water-based lubricants to the list of commodities they provide to low- and middle-income countries just last year.

While positive steps are being taken to increase the availability of lubricant, barriers continue to affect its distribution. For example, the categorisation of lubricant as a product (e.g. medical, cosmetic, etc) varies in different countries, which can pose legal delays at the point of import or export. Additional research is also needed to determine the safety of lubricant and its potential as a component of a combination HIV prevention approach.