Is wetter better? An evaluation of over-the-counter personal lubricants for safety and anti-HIV-1 activity

PLoS One. 2012;7(11):e48328. doi: 10.1371/journal.pone.0048328. Epub 2012 Nov 7.

Abstract

Because lubricants may decrease trauma during coitus, it is hypothesized that they could aid in the prevention of HIV acquisition. Therefore, safety and anti-HIV-1 activity of over-the-counter (OTC) aqueous- (n = 10), lipid- (n = 2), and silicone-based (n = 2) products were tested. The rheological properties of the lipid-based lubricants precluded testing with the exception of explant safety testing. Six aqueous-based gels were hyperosmolar, two were nearly iso-osmolar, and two were hypo-osmolar. Evaluation of the panel of products showed Gynol II (a spermicidal gel containing 2% nonoxynol-9), KY Jelly, and Replens were toxic to Lactobacillus. Two nearly iso-osmolar aqueous- and both silicone-based gels were not toxic toward epithelial cell lines or ectocervical or colorectal explant tissues. Hyperosmolar lubricants demonstrated reduction of tissue viability and epithelial fracture/sloughing while the nearly iso-osmolar and silicon-based lubricants showed no significant changes in tissue viability or epithelial modifications. While most of the lubricants had no measurable anti-HIV-1 activity, three lubricants which retained cell viability did demonstrate modest anti-HIV-1 activity in vitro. To determine if this would result in protection of mucosal tissue or conversely determine if the epithelial damage associated with the hyperosmolar lubricants increased HIV-1 infection ex vivo, ectocervical tissue was exposed to selected lubricants and then challenged with HIV-1. None of the lubricants that had a moderate to high therapeutic index protected the mucosal tissue. These results show hyperosmolar lubricant gels were associated with cellular toxicity and epithelial damage while showing no anti-viral activity. The two iso-osmolar lubricants, Good Clean Love and PRÉ, and both silicone-based lubricants, Female Condom 2 lubricant and Wet Platinum, were the safest in our testing algorithm.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-HIV Agents / chemistry
  • Anti-HIV Agents / pharmacology*
  • Cell Line
  • Cell Survival / drug effects
  • Cellulose / analogs & derivatives
  • Cellulose / chemistry
  • Cellulose / pharmacology
  • Epithelial Cells / drug effects
  • Epithelial Cells / physiology
  • Female
  • Glycerol / chemistry
  • Glycerol / pharmacology
  • HIV Infections / prevention & control*
  • HIV-1 / drug effects*
  • Humans
  • Lactobacillus / drug effects
  • Lubricants / chemistry
  • Lubricants / pharmacology*
  • Microbial Viability / drug effects
  • Mucous Membrane / drug effects
  • Mucous Membrane / pathology
  • Mucous Membrane / virology
  • Nonprescription Drugs
  • Osmolar Concentration
  • Phosphates / chemistry
  • Phosphates / pharmacology
  • Propylene Glycols / chemistry
  • Propylene Glycols / pharmacology
  • Silicone Gels
  • Spermatocidal Agents / chemistry
  • Spermatocidal Agents / pharmacology
  • Viscosity

Substances

  • Anti-HIV Agents
  • K-Y jelly
  • Lubricants
  • Nonprescription Drugs
  • Phosphates
  • Propylene Glycols
  • Silicone Gels
  • Spermatocidal Agents
  • Cellulose
  • Glycerol