The safety of over-the-counter and mail order lubricants commonly used in receptive anal sex needs to be comprehensively studied, says Jim Pickett from the organisation International Rectal Microbicides Advocates.
Findings presented at the M2010 Microbicides conference today suggested that some of the aqueous-based lubricants – with higher concentrations of dissolved sugars and salts than normally found in cells (hyperosmolar nature) – could increase the risk of getting a sexually-transmitted infection like HIV since they are associated with “cellular toxicity”.
Pickett said: “We need more data on lubricants which have not been tested for safety.”
This latest research was conducted in the laboratory and more trials are needed to get clear, validated information and to assess the clinical outcomes, said the investigator Dr Charlene Dezzutti from the University of Pittsburgh.
“One silicone (lubricant) tested seems to do much less damage than the aqueous lubricants,” she said.
She said the aqueous products damaged to the epithelial cells – the lining found in our mouth, nose, rectum and other parts of the body.
“This might lead to increased infection…these are not regulated compounds. If you are using a lubricant you might want to check the ingredient list and check it is condom friendly.”
The safest lubricants of the six tested were PRE and Wet Platinum.
Another study on lubricants in use by the participants seemed to confirm the lab findings.
Dr Pamina Gorbach from the University of California, Los Angeles, said: “Charlene showed in the lab what we found in large studies in two cities.”
The researchers were investigating the rectal health and behaviour of nearly 900 men and women in Baltimore and LA, in the US.
“More people who were using lubricants before their last receptive anal intercourse had sexually transmitted diseases. They were three times more likely to have a rectal STD.”
The participants were tested for the bacterial STDs gonorrhea and Chlamydia.
About half of them reporting using a lubricant when they last had anal sex and the majority preferred water-based lubricants.
Gorbach said: “So many types of lubricants were being used and they changed every day. Most men remembered the brand (not product) name and 20% were using more than one type.”
In Germany, it’s a criminal act to have sex with people without telling them you are HIV positive.
Now singer Nadja Benaissa, from that country’s popular girl band No Angels, has been charged with “causing bodily harm for failing to inform sexual partners” that she was HIV positive.
One of the three people involved in this case has since become infected with virus.
Prosecutors from Darmstadt, a town near Frankfurt, said: “She was well aware that any unprotected sexual contact can lead to the virus being passed on.”
Benaissa was arrested last year April before a performance in Frankfurt, on the “suspicion of sleeping with the men” between 2004 and 2006.
She faces up to 10 years in jail if found guilty of this offence.
Of course it’s immoral and unethical to knowingly put another person at risk, but in this case Benaissa is being held soley responsible for this new HIV infection.
What about the responsibility of her adult sexual partners: why didn’t they use condoms to protect themselves in an era when HIV is common?
Criminalising the sexual behaviour of consenting adults with or without HIV will worsen the stigma around this virus.
In South Africa, all sexual partners need to think about HIV and the risks of infection. A Cape Town survey of 24 HIV-positive men and 58 HIV-positive women found that most sex – 80% of 5000 sex acts – involved no condoms at all.
“More than half of the unprotected sex events were with HIV -negative partners or partners with unknown HIV status,” said the researchers, who were led by Dr Susan Kiene and Dr Leickness Simbayi.
Another study of HIV risk among 15- to 24-year-old females and their older male partners, or “sugar daddies”, found both parties wrongly believed the other to be at low risk for HIV .
It’s time for every sexually active person to be responsible for himself or herself.
An important new study on AIDS treatment in the private sector in Southern Africa examines what drives up costs in HIV management – and many of these findings also apply to the public sector.
The researchers analysed the direct costs in treating more than 10 000 “HIV-infected adults are enrolled in managed care programmes” from three years before ARV initiation up to five years afterwards and the results are published in the current issue of PLos Medicine.
They found: “There was a peak in costs in the period around ART initiation (from 4 months before until 4 months after starting ART) driven largely by hospitalisation, following which costs plateaued for 5 years.”
Rory Leisegang, from UCT’s Clinical Pharmacology division in the Department of Medicine, and his co-authors concluded: “Starting ART at higher CD4 counts or longer pre-ART care should reduce early costs.
“Monitoring ART adherence and interventions to improve it should reduce later costs.”
President of the HIV Clinicians Society of Southern Africa, Dr Francois Venter, commented: “$2400 annually in direct costs, once accounting for the early hospital; costs, is a bit over double that in the state sector.
“The hospitalization rates were similar, but that probably is because of a higher bar to hospitalization for state patients (which also again drives cost). As expected, poor adherence impact on costs.”
Young scientists around their world are finding clues to crack the puzzle of what it will take to make an effective HIV vaccine.
Speaking at the AIDS Vaccine 2009 conference in Paris this afternoon they reported on pioneering work, most of which revolved around a type of cells known as denditric cells.
*Mathias Lichterfeld from Massachusetts General Hospital in Boston, US, explained: “Denditric cells are like the conductors of a concert. They are what get effector cells working: they prime T-cell (cellular) response and B-cell (antibody) responses.”
Elite controllers – a rare group of people who have HIV but keep it under control – have extremely effective denditric cells compared to other people with HIV or those who are HIV negative, his work has shown. “Manipulating denditric cells is an important element to any (HIV) vaccine,” he said.
*Jacques Bancherau from INSERM/Center for Human Vaccines in Texas, US, said his team was working on targeting and manipulating denditric cells, which he has been researching among cancer patients for 10 years.
“ One year ago we started injecting them into HIV patients and we have found this is safe. We need a proof of concept study on whether there is a future in manipulating these cells.”
He said if this proved to effective, it would be a “new methodology for HIV vaccine” that could be done anywhere off the shelf.
*Michael Liu from Oxford University said he was researching what happens to the T-cell response among patients very early on when they are infected. “We have found that T-cells have an effect on the virus in the early stages but that the virus can escape easily.”
*Sylvie le Gall from Harvard Medical School said her team was working on how the immune cells could improve their recognition of infected cells – research that could benefit the immune design of a vaccine candidate.
“We want to improve immune design. We want to improve the presentation of epitopes (a part of the virus surface that the body’s immune system targets for destruction) to evoke strong immune protection and to avoid epitopes that are useless.”