title: The slippery slope: lubricant use and rectal sexually transmitted infections: a newly identified risk.
abstract: BACKGROUND
  Use of lubricant products is extremely common during receptive anal intercourse (RAI) yet has not been assessed as a risk for acquisition of sexually transmitted infections (STIs).
  
  
  METHODS
  Between 2006 and 2008, a rectal health and behavior study was conducted in Baltimore and Los Angeles as part of the University of California, Los Angeles Microbicide Development Program (NIAID IPCP# #0606414). Participants completed questionnaires, and rectal swabs were tested for Neisseria gonorrhoeae and Chlamydia trachomatis with the Aptima Combo 2 assay, and blood was tested for syphilis (for RPR and TPHA with titer) and HIV. Of those reporting lubricant use and RAI, STI results were available for 380 participants. Univariate and multivariate regressions assessed associations of lubricant use in the past month during RAI with prevalent STIs.
  
  
  RESULTS
  Consistent lubricant use during RAI in the past month was reported by 36% (137/380) of participants. Consistent past month lubricant users had a higher prevalence of STI than inconsistent users (9.5% vs. 2.9%; P = 0.006). In a multivariable logistic regression model, testing positive for STI was associated with consistent use of lubricant during RAI in the past month (adjusted odds ratio: 2.98 95% confidence interval: 1.09, 8.15) after controlling for age, gender, study location, HIV status, and numbers of RAI partners in the past month.
  
  
  CONCLUSIONS
  Findings suggest some lubricant products may increase vulnerability to STIs. Because of wide use of lubricants and their potential as carrier vehicles for microbicides, further research is essential to clarify if lubricant use poses a public health risk.
authors.affiliation: Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA 90095-1772, USA. pgorbach@ucla.edu
authors.forename: Pamina M
authors.initials: PM
authors.lastname: Gorbach
authors.forename: Robert E
authors.initials: RE
authors.lastname: Weiss
authors.forename: Edward
authors.initials: E
authors.lastname: Fuchs
authors.forename: Robin A
authors.initials: RA
authors.lastname: Jeffries
authors.forename: Marjan
authors.initials: M
authors.lastname: Hezerah
authors.forename: Stephen
authors.initials: S
authors.lastname: Brown
authors.forename: Alen
authors.initials: A
authors.lastname: Voskanian
authors.forename: Edward
authors.initials: E
authors.lastname: Robbie
authors.forename: Peter
authors.initials: P
authors.lastname: Anton
authors.forename: Ross D
authors.initials: RD
authors.lastname: Cranston
mesh_terms: D000293:Adolescent; D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D002690:Chlamydia Infections / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D054327:Lubricants / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D015995:Prevalence; D011634:Public Health; D018570:Risk Assessment; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000453:epidemiology; D014210:Treponema pallidum / Q000302:isolation & purification*; D055815:Young Adult
chemical_list: D054327:Lubricants