Preference and practices relating to lubricant use during anal intercourse: implications for rectal microbicides.
BACKGROUND
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.


METHODS
We conducted an internet-based survey using a 25-item questionnaire to assess AI and lubricant use, including lubricant preferences and barriers to use.


RESULTS
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.


CONCLUSIONS
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.
Javanbakht
Marjan
M
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. javan@ucla.edu
Murphy
Ryan
R
Gorbach
Pamina
P
LeBlanc
Marc-André
MA
Pickett
Jim
J
D000285:Administration, Rectal; D000328:Adult; D001003:Anal Canal; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D003075:Coitus; D016001:Confidence Intervals; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D054327:Lubricants / Q000008:administration & dosage*; D008153:Lubrication / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D015229:Sexually Transmitted Diseases, Viral / Q000517:prevention & control; D011795:Surveys and Questionnaires; D055815:Young Adult
D000891:Anti-Infective Agents, Local; D054327:Lubricants