Widely used nonspermicidal lubricants may have previously unsuspected anti-HIV effects, according to research presented at HIV DART 2000: Frontiers in Drug Development for Antiretroviral Therapies, held in Isla Verde, Puerto Rico between December 17 and 21, 2000.
Until now, the benefits of increased lubrication during sexual activity have mainly been related to the reduction in abrasion and in providing a physical barrier to HIV transmission across the vaginal and rectal mucosa. Some spermicidal agents, such as nonoxynol-9, have been assessed in clinical trials and are already marketed to prevent pregnancy.
Some spermicides may also have anti-HIV effects, but none has been proven to reduce rates of HIV acquisition, and nonoxynol-9 has been associated with increased rates of HIV infection when used in unprotected vaginal sex, presumably because of counterproductive irritant effects upon the mucosa.
In the study presented, Samuel Baron and colleagues from the University of Texas assessed the ability of FDA-approved "over the counter" (OTC) lubricants, marketed for use during sexual intercourse, to inhibit HIV activity. Of the 22 products that were assessed, 4 (Astroglide, KY-Liquid, Vagisil, and viAmor) were highly effective against HIV-infected leucocytes suspended in seminal fluid and against cell-free HIV. In addition, the antiretroviral activity was observed both when the HIV-infected plasma was layered with the lubricant or mixed with it. Two of these agents also showed substantial (greater than 1000-fold) inhibition of monocyte HIV production. This effect appeared to develop during the first 5 to 20 minutes of exposure and persisted for at least 8 hours at 37.0 degrees Centigrade.
According to Dr Mike Youle, from the Royal Free Hospital in London, United Kingdom, this study "may open the doors to a practical approach to investigate the usefulness of simple OTC lubricants to assist in prevention of HIV transmission. It seems surprising that this study has only just been done, 20 years into the HIV epidemic. Certainly it should guide the provision of lubricants and lubricated condoms in health promotion strategies."
Editorial note: This study should not be taken to imply that all water based lubricants have an innate anti-HIV effect. The investigators found that 18 of the 22 lubricants tested DID NOT inhibit HIV, and they stress that until further tests have been carried out, these findings should not be taken to imply that use of any of the four water based lubricants alone will provide adequate protection against HIV infection.
Baron S et al. Practical curtailment of the HIV epidemic by adapting the potent oral defense to topically prevent vaginal and rectal transmission. Antiviral Research HIV DART, Peurto Rico, abstract 032, 2000.