Geibel, S. Journal of the International AIDS Society (2013), Vol. 16.
Geibel reviewed evidence on lubricants in terms of their effects on and compatibility with condoms and their biological safety. The author also discussed documentation of lubricant use and relevance to current guidance for HIV prevention in Africa. While improving, evidence on the safety of and compatibility between lubricants and condoms is not well documented, and criteria for lubricant safety and procurement are needed. Water-based lubricants remain expensive in sub-Saharan Africa, and their potential HIV risks are insufficiently documented. Because of the scarcity and high cost of water-based lubricants, the author explained that many Africans use numerous lubricants, including household or oil-based products of unknown safety. Safety regulations on lubricants, particularly products not marketed for sexual use, may not be rigorous. Current guidance does not indicate preferred lubricants or clarify the safety of lubricants, but some guidelines from international organizations advise avoiding oil-based products and list products that damage latex. Organizations such as the International Rectal Microbicides Advocates monitor research to provide guidance on lubricant safety and to advocate for continued research. Population-based surveys in Africa, not only with key populations, should further evaluate lubricant use, type, and accessibility. Further research and guidance from the Food and Drug Administration are needed to address safety and ensure that public health professionals market lubricants that do not increase HIV risk.