et al. et al. et al. et al. et al. et al. et al. et al. et al. et al. et al. et al. et al.
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

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

Marjan Javanbakht A C , Ryan Murphy A , Pamina Gorbach A , Marc-André LeBlanc B and Jim Pickett B

A 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.

B International Rectal Microbicide Advocates, 411 South Wells Street, Suite 300, Chicago, IL 60607, USA.

C Corresponding author. Email: javan@ucla.edu

Sexual Health 7(2) 193-198 https://doi.org/10.1071/SH09062
Submitted: 10 June 2009  Accepted: 23 February 2010   Published: 14 May 2010

Abstract

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.

Additional keywords: condoms, HIV, safer sex, STIs, survey.


References


[1] Padian N,  Marquis L,  Francis DP,  Anderson RE,  Rutherford GW,  O’Malley PM, et al. Male-to-female transmission of human immunodeficiency virus. JAMA 1987; 258 788–90.
CrossRef |

[2] Royce RA,  Sena A,  Cates W,  Cohen MS. Sexual transmission of HIV. N Engl J Med 1997; 336 1072–8.
CrossRef |

[3] Chirgwin KD,  Feldman J,  Dehovitz JA,  Minkoff H,  Landesman SH. Incidence and risk factors for heterosexually acquired HIV in an inner-city cohort of women: temporal association with pregnancy. J Acquir Immune Defic Syndr Hum Retrovirol 1999; 20 295–9.


[4] Leichliter JS,  Chandra A,  Liddon N,  Fenton KA,  Aral SO. Prevalence and correlates of heterosexual anal and oral sex in adolescents and adults in the United States. J Infect Dis 2007; 196 1852–9.
CrossRef |

[5] Mosher WD,  Chandra A,  Jones J. Sexual behavior and selected health measures: men and women 15–44 years of age, United States, 2002. Adv Data 2005; 362 1–55.


[6] Flannery D,  Ellingson L,  Votaw KS,  Schaefer EA. Anal intercourse and sexual risk factors among college women, 1993–2000. Am J Health Behav 2003; 27 228–34.


[7] Baldwin JI,  Baldwin JD. Heterosexual anal intercourse: an understudied, high-risk sexual behavior. Arch Sex Behav 2000; 29 357–73.
CrossRef |

[8] MacDonald NE,  Wells GA,  Fisher WA,  Warren WK,  King MA,  Doherty JA, et al. High-risk STD/HIV behavior among college students. JAMA 1990; 263 3155–9.
CrossRef |

[9] Satterwhite CL,  Kamb ML,  Metcalf C,  Douglas JM,  Malotte CK,  Paul S, et al. Changes in sexual behavior and STD prevalence among heterosexual STD clinic attendees: 1993–1995 versus 1999–2000. Sex Transm Dis 2007; 34 815–9.


[10] Koblin BA,  Hoover DR,  Xu G,  Frye V,  Latka MH,  Lucy D, et al. Correlates of anal intercourse vary by partner type among substance-using women: baseline data from the UNITY study. AIDS Behav 2010; 14 132–40.
CrossRef |

[11] Tian LH,  Peterman TA,  Tao G,  Brooks LC,  Metcalf C,  Malotte CK, et al. Heterosexual anal sex activity in the year after an STD clinic visit. Sex Transm Dis 2008; 35 905–9.
CrossRef |

[12] Cowan SA,  Haff J. HIV and risk behaviour among men who have sex with men in Denmark – the 2006 Sex Life Survey. Euro Surveill 2008; 13 1–6.


[13] Erickson PI,  Bastani R,  Maxwell AE,  Marcus AC,  Capell FJ,  Yan KX. Prevalence of anal sex among heterosexuals in California and its relationship to other AIDS risk behaviors. AIDS Educ Prev 1995; 7 477–93.


[14] DiClemente RJ,  Wingood GM,  Crosby RA,  Salazar LF,  Head S,  Rose E, et al. Anal sex is a behavioural marker for laboratory-confirmed vaginal sexually transmissible infections and HIV-associated risk among African-American female adolescents. Sex Health 2009; 6 111–6.
CrossRef |

[15] Kilmarx PH,  van de Wijgert JH,  Chaikummao S,  Jones HE,  Limpakarnjanarat K,  Friedland BA, et al. Safety and acceptability of the candidate microbicide Carraguard in Thai women: findings from a phase II clinical trial. J Acquir Immune Defic Syndr 2006; 43 327–34.
CrossRef |

[16] Rosen RK,  Morrow KM,  Carballo-Dieguez A,  Mantell JE,  Hoffman S,  Gai F, et al. Acceptability of Tenofovir gel as a vaginal microbicide among women in a phase I trial: a mixed-methods study. J Women’s Health 2008; 17 383–92.
CrossRef |

[17] Ramjee G,  Morar NS,  Braunstein S,  Friedland B,  Jones H,  van de Wijgert J. Acceptability of Carraguard, a candidate microbicide and methyl cellulose placebo vaginal gels among HIV-positive women and men in Durban, South Africa. AIDS Res Ther 2007; 4 20.
CrossRef |

[18] Joglekar N,  Joshi S,  Kakde M,  Fang G,  Cianciola M,  Reynolds S, et al. Acceptability of PRO2000 vaginal gel among HIV un-infected women in Pune, India. AIDS Care 2007; 19 817–21.
CrossRef |

[19] Trottier S,  Omar RF,  Desormeaux A,  Drouin J,  Gagnon MT,  Vezina F, et al. Safety, tolerance and acceptability of the Invisible Condom and its vaginal applicator in healthy women and their male sexual partners. Contraception 2007; 76 117–25.
CrossRef |

[20] Nodin N,  Carballo-Dieguez A,  Ventuneac AM,  Balan IC,  Remien R. Knowledge and acceptability of alternative HIV prevention bio-medical products among MSM who bareback. AIDS Care 2008; 20 106–15.
CrossRef |

[21] Carballo-Dieguez A,  Stein Z,  Saez H,  Dolezal C,  Nieves-Rosa L,  Diaz F. Frequent use of lubricants for anal sex among men who have sex with men: the HIV prevention potential of a microbicidal gel. Am J Public Health 2000; 90 1117–21.
CrossRef |

[22] Gross M,  Buchbinder SP,  Celum C,  Heagerty P,  Seage GR. Rectal microbicides for U.S. gay men. Are clinical trials needed? Are they feasible? HIVNET Vaccine Preparedness Study Protocol Team. Sex Transm Dis 1998; 25 296–302.
CrossRef |

[23] Carballo-Dieguez A,  Dolezal C,  Bauermeister JA,  O’Brien W,  Ventuneac A,  Mayer K. Preference for gel over suppository as delivery vehicle for a rectal microbicide: results of a randomised, crossover acceptability trial among men who have sex with men. Sex Transm Infect 2008; 84 483–7.
CrossRef |

[24] Carballo-Dieguez A,  Exner T,  Dolezal C,  Pickard R,  Lin P,  Mayer KH. Rectal microbicide acceptability: results of a volume escalation trial. Sex Transm Dis 2007; 34 224–9.
CrossRef |

[25] Ventuneac A,  Carballo-Dieguez A,  McGowan I,  Dennis R,  Adler A,  Khanukhova E, et al. Acceptability of UC781 gel as a rectal microbicide among HIV-uninfected women and men. AIDS Behav 2010;
CrossRef |

[26] Rader M,  Marks G,  Mansergh G,  Crepaz N,  Miller LC,  Appleby PR, et al. Preferences about the characteristics of future HIV prevention products among men who have sex with men. AIDS Educ Prev 2001; 13 149–59.
CrossRef |

[27] Mantell JE,  Myer L,  Carballo-Dieguez A,  Stein Z,  Ramjee G,  Morar NS, et al. Microbicide acceptability research: current approaches and future directions. Soc Sci Med 2005; 60 319–30.
CrossRef |

[28] Elford J,  Bolding G,  Davis M,  Sherr L,  Hart G. Web-based behavioral surveillance among men who have sex with men: a comparison of online and offline samples in London, UK. J Acquir Immune Defic Syndr 2004; 35 421–6.
CrossRef |

[29] Rhodes SD,  Bowie DA,  Hergenrather KC. Collecting behavioural data using the world wide web: considerations for researchers. J Epidemiol Community Health 2003; 57 68–73.
CrossRef |

[30] Soni S,  Bond K,  Fox E,  Grieve AP,  Sethi G. Black and minority ethnic men who have sex with men: a London genitourinary medicine clinic experience. Int J STD AIDS 2008; 19 617–9.
CrossRef |



Rent Article (via Deepdyve) Export Citation Cited By (18)