Personal or additional lubricants are used by individuals to enhance sexual experience. Lubrication norms during sex are linked to factors including sociocultural norms, gender dynamics, age, and education. This article provides an overview of literature, exploring thematic areas of interest and relevance to the topic. In some regions/countries, lubricated sex is preferable, and in others, a dry/tight vagina is preferred. Women may use a variety of products to achieve these states. There is little research on lubrication preferences during sex; however, microbicide gel acceptability and adherence studies have provided some insight into these preferences. There is a need for more information on lubrication preferences, including volumes, frequency of use, and site of application. In addition, condom use with lubricants needs further exploration. Context, gender, and individual preferences have implications for acceptability and use of personal additional lubricants and should be taken into account during marketing and dissemination of these products.
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Abdool Karim, Q., Abdool Karim, S. S., Frohlich, J., Grobler, A., Baxter, C., Mansoor, L. E., & CAPRISA 004 Trial Group. (2010). Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science,329(5996), 1168–1174.
Allen, C. F., Desmond, N., Chiduo, B., Medard, L., Lees, S. S., Vallely, A., & Hayes, R. J. (2010). Intravaginal and menstrual practices among women working in food and recreational facilities in Mwanza, Tanzania: Implications for microbicide trials. AIDS and Behavior,14(5), 1169–1181. https://doi.org/10.1007/s10461-010-9750-8.
AVERT. (2016). Condoms and lubricants: Fact sheet. Retrieved from: https://www.avert.org/learn-share/hiv-fact-sheets/condoms-lubricants. Date retrieved: 26 Feb 2020.
Beksinska, M. E., Rees, H. V., Kleinschmidt, I., & McIntyre, J. (1999). The practice and prevalence of dry sex among men and women in South Africa: A risk for sexually transmitted diseases. Sexually Transmitted Infections,75(3), 178–180.
Bentley, M. E., Fullem, A. M., Tolley, E. E., Kelly, C. W., Jogelkar, N., Srirak, N., & Celentano, D. D. (2004). Acceptability of a microbicide among women and their partners in a 4-country Phase I trial. American Journal of Public Health,94(7), 1159–1164.
Braunstein, S., & Van de Wijgert, J. (2005). Preferences and practices related to vaginal lubrication: Implications for microbicide acceptability and clinical testing. Journal of Women’s Health,14(5), 424–433.
Brown, J. E., & Brown, R. C. (2000). Traditional intravaginal practices and the heterosexual transmission of disease: A review. Sexually Transmitted Diseases,27(4), 183–187.
Brown, J., Sorrell, J., & Raffaelli, M. (2005). An exploratory study of constructions of masculinity, sexuality and HIV/AIDS in Namibia, Southern Africa. Culture, Health and Sexuality,7(6), 585–598.
Carballo-Dieguez, A., Balan, I., Morrow, K., Rosen, J. E., et al. (2007). Acceptability of tenofovir gel as a vaginal microbicide by US male participants in a Phase I clinical trial (HPTN 050). AIDS Care,19(8), 1026–1031.
Carballo-Dieguez, A., Giguere, R., Dolezal, C., Chen, B. A., Kahn, J., Zimet, G., & McGowan, I. (2012). “Tell Juliana”: Acceptability of the candidate microbicide VivaGel(R) and two placebo gels among ethnically diverse, sexually active young women participating in a Phase 1 microbicide study. AIDS and Behavior,16(7), 1761–1774.
Doggett, E. G., Lanham, M., Wilcher, R., Gafos, M., Karim, Q. A., & Heise, L. (2015). Optimizing HIV prevention for women: A review of evidence from microbicide studies and considerations for gender-sensitive microbicide introduction. Journal of the International AIDS Society,18, 20536. https://doi.org/10.7448/IAS.18.1.20536.
Fonck, K., Kaul, R., Kimani, J. K., Keli, F., MacDonald, K. S., Ronald, A. R., & Temmerman, M. (2000). A randomized, placebo-controlled trial of monthly azithromycin prophylaxis to prevent sexually transmitted infections and HIV-1 in Kenyan sex workers: Study design and baseline findings. International Journal of STDs and AIDS,11(12), 804–811.
Frasca, T., Giguere, R., Ibitoye, M., Dolezal, C., Febo, I., Cranston, R. D., & Carballo-Dieguez, A. (2016). Lessons for rectal microbicide development from an acceptability trial of a placebo gel applied prior to receptive anal intercourse. Archives of Sexual Behavior,46(4), 1101–1109.
Gabbay, M., & Gibbs, A. (1996). Does additional lubrication reduce condom failure? Contraception,53(3), 155–158.
Gafos, M., Mzimela, M., Ndlovu, H., Mhlongo, N., Hoogland, Y., & Mutemwa, R. (2011). “One teabag is better than four”: Participants response to the discontinuation of a 2% PRO2000/5 microbicide gel in KwaZulu-Natal, South Africa. PloS ONE,6(1), e14577. https://doi.org/10.1371/journal.pone.0014577.
Gafos, M., Mzimela, M., Sukazi, S., Pool, R., Montgomery, C., & Elford, J. (2010). Intravaginal insertion in KwaZulu-Natal: Sexual practices and preferences in the context of microbicide gel use. Culture, Health and Sexuality,12(8), 929–942.
Gafos, M., Pool, R., Mzimela, M., Ndlovu, H., McCormack, S., & Elford, J. (2015). Communication about microbicide use between couples in KwaZulu-Natal South Africa. AIDS and Behavior,19(5), 832–846.
Geibel, S. (2013). Condoms and condiments: Compatibility and safety of personal lubricants and their use in Africa. Journal of the International AIDS Society,16, 18531. https://doi.org/10.7448/IAS.16.1.18531.
Golombok, R., Harding, R., & Sheldon, J. (2001). An evaluation of a thicker versus a standard condom with gay men. AIDS,15(2), 245–250.
Grant, M. J., & Booth, A. (2009). A typology of reviews: An analysis of 15 review types and associated methodologies. Health Information and Libraries Journal,26, 91–108.
Greene, E., Batona, G., Hallad, J., Johnson, S., Neema, S., & Tolley, E. E. (2010). Acceptability and adherence of a candidate microbicide gel among high-risk women in Africa and India. Culture, Health and Sexuality,12(7), 739–754.
Guest, G., Johnson, L., Burke, H., Rain-Taljaard, R., Severy, L. J., Von Mollendorf, C., & van Damme, L. (2007). Changes in sexual behaviour during a safety and feasibility trial of a microbicide/diaphragm combination: An integrated qualitative and quantitative analysis. AIDS Education and Prevention,19(4), 310–320.
Hart, C. W., Joanis, C., Hartmann, M., Milford, C., Smit, J., Beksinska, M., & Jenkins, D. (2019). Acceptability and performance of a nonwoven device for vaginal drug delivery among women and their male partners in KwaZulu-Natal, South Africa. European Journal of Contraception and Reproductive Health Care,24(5), 390–398.
Herbenick, D., Reece, M., Hensel, D., Sanders, S., Jozkowski, K., & Fortenberry, D. (2011). Association of lubricant use with women’s sexual pleasure, sexual satisfaction, and genital symptoms: A prospective daily diary study. Journal of Sexual Medicine,8, 202–212.
Herbenick, D., Schick, V., Reece, M., Sanders, S. A., Smith, N., Dodge, B., & Fortenberry, J. D. (2013). Characteristics of condom and lubricant use among a nationally representative probability sample of adults ages 18-59 in the United States. Journal of Sexual Medicine,10, 474–483.
Hilber, A. M., Chersich, M. F., Van de Wijgert, J., Rees, H., & Temmerman, M. (2007). Vaginal practices, microbicides and HIV: What do we need to know? Sexually Transmitted Infections,83, 505–508.
Hilber, A. M., Francis, S. C., Chersich, M. F., Scott, P., Redmond, S., Bender, N., & Temmerman, M. (2010). Intravaginal practices, vaginal infections and HIV acquisition: Systematic review and meta-analysis. PLoS ONE,5(2), e9119. https://doi.org/10.1371/journal.pone.0009119.g001.
Hoffman, S., Morrow, K. M., Mantell, J. E., Rosen, R. K., Carballo-Dieguez, A., & Gai, F. (2010). Covert use, vaginal lubrication, and sexual pleasure: A qualitative study of urban U.S. women in a vaginal microbicide clinical trial. Archives of Sexual Behavior,39, 748–760.
Hull, T., Hilber, A. M., Chersich, M. F., Bagnol, B., Prohmmo, A., Smit, J. A., & Temmerman, M. (2011). Prevalence, motivations, and adverse effects of vaginal practices in Africa and Asia: Findings from a multi-country household survey. Journal of Women’s Health,20(7), 1–13.
International Partnership for Microbicides. (2017). What are microbicides? Retrieved from http://www.ipmglobal.org/why-microbicides/arv-based-microbicides-and-how-they-work/what-are-microbicides.
Janneke, H. H. M., Van de Wijgert, J., Khumalo-Sakutukwa, G., Coggins, C., Dube, S., Nyamapfeni, P., & Padian, N. (1999). Men’s attitudes toward vaginal microbicides and microbicide trials in Zimbabwe. International Family Planning Perspectives,25(1), 15–20.
Jogelkar, N., Kakde, J. M., Fang, G., Cianciola, M., Reynolds, S., Mehendale, S., & H. P. T. (2007). Acceptability of PRO2000 vaginal gel among HIV un-infected women in Pune, India. AIDS Care,19(6), 817–821.
Jones, H. E., Chaikummao, S., Van de Wijgert, J., Friedland, B. A., Manopaiboon, C., Witwatwongwana, P., & Kilmarx, P. H. (2009). Acceptability of carrageenan-based candidate vaginal microbicide and matching placebo: Findings from a Phase II safety trial among women in Chiang Rai, Thailand. Journal of Women’s Health,18(7), 1003–1009.
Jones, D. L., Weiss, S. M., Chitalu, N., Mumbi, R. N., Shine, A., Vamos, S., & Villar, O. (2008). Acceptability and use of sexual barrier products and lubricants among HIV-seropositve Zambian men. AIDS Patient Care and STDs,22(12), 1015–1020.
Jozkowski, K. N., Herbenick, D., Schick, V., Reece, M., Sanders, S., & Fortenberry, J. D. (2013). Women’s perceptions about lubricant use and vaginal wetness during sexual activities. Journal of Sexual Medicine,10, 484–492.
Lee, M., Sandfort, T., Collier, K., Lane, T., & Reddy, V. (2016). Breakage is the norm: Use of condoms and lubrication in anal sex among Black South African men who have sex with men. Culture, Health and Sexuality,19(4), 501–514.
Lees, S. (2015). Emergent HIV technology: Urban Tanzanian women’s narratives of medical research, microbicides and sexuality. Culture, Health and Sexuality,17(4), 412–427.
Leiblum, S. R., Hayes, R. D., Wanser, R. A., & Nelson, J. S. (2009). Vaginal dryness: A comparison of prevalence and interventions in 11 countries. Journal of Sexual Medicine,6(9), 2425–2433.
Levin, R. J. (2005). Wet and dry sex—the impact of cultural influence in modifying vaginal function. Sexual and Relationship Therapy,20(4), 465–474.
Mantell, J. E., Morar, N. S., Myer, L., & Ramjee, G. (2006). “We have our protector”: Misperceptions of protection against HIV among participants in a microbicide efficacy trial. American Journal of Public Health,96(6), 1073–1077.
Martin, S., Blanchard, K., Manopaiboon, C., Chaikummao, S., Schaffer, K., Friedland, B., & Kilmarx, P. H. (2010). Carraguard acceptability among men and women in a couples study in Thailand. Journal of Women’s Health,19(8), 1561–1567.
Moench, T. R., Mumper, R. J., Hoen, T. E., Sun, M., & Cone, R. A. (2010). Microbicide excipients can greatly increase susceptibility to genital herpes transmission in the mouse. BMC Infectious Diseases,10, 331. https://doi.org/10.1186/1471-2334-10-331.
Montgomery, E. T., Beksinska, M., Mgodi, N., Schwartz, K., Weinrib, R., Brown, E. N., & Van der Straten, A. (2019). End-user preference for and choice of four vaginally delivered HIV prevention methods among young women in South Africa and Zimbabwe: The Quatro Clinical Crossover Study. Journal of the International AIDS Society,22, e25283. https://doi.org/10.1002/jia2.25283.
Montgomery, E. T., Blanchard, K., Cheng, H., Chipato, T., de Bruyn, G., Ramjee, G., & M Team. (2009). Diaphragm and lubricant gel acceptance, skills and patterns of use among women in an effectiveness trial in Southern Africa. European Journal of Contraception and Reproductive Health Care,14(6), 410–419.
Montgomery, E. T., Cheng, H., van der Straten, A., Chidanyika, A. C., Lince, N., Blanchard, K., & M Team. (2010a). Acceptability and use of the diaphragm and Replens lubricant gel for HIV prevention in Southern Africa. AIDS and Behavior,14(3), 629–638.
Montgomery, C. M., Gafos, M., Lees, S., Morar, N. S., Mweemba, O., Ssali, A., & Team, M. D. P. (2010b). Re-framing microbicide acceptability: Findings from the MDP301 trial. Culture, Health and Sexuality,12(6), 649–662.
Mweemba, O., Dixey, R., Bond, V., & White, A. (2018). The influence of social constructs of hegemonic masculinity and sexual behaviour on acceptability of vaginal microbicides in Zambia. Global Public Health, 13, 931–943.
Pistorius, A., van de Wijgert, J., Sebola, M., Friedland, B., Nagel, E., Bokaba, C., & Hoosen, A. (2004). Microbicide trials for preventing HIV/AIDS in South Africa: Phase II trial participants’ experiences and psychological needs. SAHARA-J: Journal of Social Aspects of HIV/AIDS,1(2), 78–86.
Primrose, R. J., Zaveri, T., Bakke, A. J., Ziegler, G. R., Moskowitz, H. R., & Hayes, J. E. (2016). Drivers of vaginal drug delivery system acceptability from internet-based conjoint analysis. PLoS ONE,11(3), e0150896. https://doi.org/10.1371/journal.pone.0150896
Ramjee, G., Morar, N. S., Braunstein, S., Friedland, B., Jones, H., & van de Wijgert, J. (2007). Acceptability of Carraguard, a candidate microbicide and methyl cellulose placebo vaginal gels among HIV-positive women and men in Durban, South Africa. AIDS Research and Therapy,4, 20. https://doi.org/10.1186/1742-6405-4-20
Romijinders, K. A., Nyoni, J. E., Ross, M. W., McCurdy, S. A., Mbwambo, J., Kok, G., & Crutzen, R. (2016). Lubricant use and condom use during anal sex in men who have sex with men in Tanzania. International Journal of STDs and AIDS,27(14), 1289–1302.
Rosen, R. K., Morrow, K. M., Carballo-Dieguez, A., Mantell, J. E., Hoffman, S., Gai, F., & Mayer, K. H. (2008). Acceptability of tenofovir gel as a vaginal microbicide among women in a Phase I trial: A mixed-methods study. Journal of Women’s Health,17(3), 383–392.
Sahin-Hodoglugil, N. N., Montgomery, E., Kacanek, D., Morar, N., Mtetwa, S., Nkala, B., & Team, The M. I. R. A. (2011). User experiences and acceptability attributes of the diaphragm and lubricant gel in an HIV prevention trial in southern Africa. AIDS Care,23(8), 1026–1034.
Sanders, S. A., Crosby, R. A., Milhausen, R. R., Graham, C. A., Tirmizi, A., Yarber, W. L., & Mena, L. (2017). Women’s willingness to experiment with condoms and lubricants: A study of women residing in a high HIV seroprevalence area. International Journal of STD and AIDS,29, 367–374.
Short, M. B., Succop, P. A., Rupp, R., & Rosenthal, S. L. (2008). Adolescents’ reasons for using a microbicide-like product over time. International Journal of STD and AIDS,19(2), 115–117.
Smith, A. M., Jolley, D., Hocking, J., Benton, K., & Gerofi, J. (1998). Does additional lubrication affect condom slippage and breakage? International Journal of STDs and AIDS,9(6), 330–335.
Stadler, J., Delany-Moretlwe, S., Palanee, T., & Rees, H. (2014). Hidden harms: Women’s narratives of intimate partner violence in a microbicide trial, South Africa. Social Science and Medicine,110, 49–55.
Stadler, J., & Saethre, E. (2011). Blockage and flow: Intimate experiences of condoms and microbicides in a South African clinical trial. Culture, Health and Sexuality,13(1), 31–44.
Sutton, K. S., Boyer, S. C., Goldfinger, C., Ezer, P., & Pukall, C. F. (2012). To lube or not to lube: Experiences and perceptions of lubricant use in women with and without dyspareunia. Journal of Sexual Medicine,9(1), 240–250.
Tanner, A. E., Fortenberry, J. D., Zimet, G. D., Reece, M., Graham, C. A., & Murray, M. (2010). Young women’s use of a microbicide surrogate: The complex influence of relationship characteristics and perceived male partners’ evaluations. Archives of Sexual Behavior,39(3), 735–747.
Tolley, E. E., Eng, E., Kohli, R., Bentley, M. E., Mehendale, S., Bunce, A., & Severy, L. J. (2006). Examining the context of microbicide acceptability among married women and men in India. Culture, Health and Sexuality,8(4), 351–369.
UNAIDS. (2014). Condom and lubricant programming in high HIV prevalence countries. Retrieved from: https://www.unaids.org/en/resources/documents/2015/Condomlubricantprogramming.
van den Berg, J. J., Rosen, R. K., Bregman, D. E., Thompson, L. A., Jensen, K. M., Kiser, P. F., & Morrow, K. M. (2014). “Set it and forget it”: Women’s perceptions and opinions of long-acting topical vaginal gels. AIDS and Behavior,18(5), 862–870.
Veldhuijzen, N., Nyinawabega, J., Umulisa, M., Kankindi, B., Geubbels, E., Basinga, P., & Van De Wijgert, J. (2006). Preparing for microbicide trials in Rwanda: Focus group discussions with Rwandan women and men. Culture, Health and Sexuality,8(5), 395–406.
Venables, E., & Stadler, J. (2012). ‘The study has taught me to be supportive of her’: Empowering women and involving men in microbicide research. Culture, Health and Sexuality,14(2), 181–194.
Wang, Y., Jiang, Y., Lu, L., Wang, G., Bi, A., Fang, H., & Wang, W. (2010). Microbicide acceptability and associated factors among female sex workers and male clients in Kaiyuan County, Yunnan Province, China. Journal of Acquired Immunce Deficiency Syndromes,53(Supp1), S93–S97.
Whitehead, S. J., McLean, C., Chaikummao, S., Braunstein, S., Utaivoravit, W., van de Wijgert, J. H., & Markowitz, L. E. (2011). Acceptability of Carraguard vaginal microbicide gel among HIV-infected women in Chiang Rai, Thailand. PLoS ONE,6(9), e14831. https://doi.org/10.1371/journal.pone.0014831.
WHO, Unfpa, UNAIDS, NSWP, World Bank, & UNDP. (2013). Implementing comprehensive HIV/STI programmes with sex workers: Practical approaches from collaborative interventions. Geneva: World Health Organization.
Woodsong, C., & Alleman, P. (2008). Sexual pleasure, gender power and microbicide acceptability in Zimbabwe and Malawi. AIDS Education and Prevention,20(2), 171–187.
World Health Organization. (2012a). A multi-country study on gender, sexuality and vaginal practices: Implications for sexual health: Policy brief. Geneva: Author.
World Health Organization. (2012b). Use and procurement of additional lubricants for male and female condoms: WHO/UNFPA/FHI360: Advisory note. Geneva: Author.
This paper was developed following recommendations from the Global Consultation on Personal Lubricants held in Bangkok, Thailand, November 8–10, 2016, hosted by the United Nations Population Fund, World Health Organization (WHO), the United States Agency for International Development and the International Planned Parenthood Federation. The write-up was supported by the UNFPA under UNFPA/USA/PSC/. We are grateful to Richard Cone, Johns Hopkins University, for the review of this paper and would also like to acknowledge Lavanya Pillay for assisting with the literature review.
The write-up was supported by the UNFPA under UNFPA/USA/PSC/.
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Milford, C., Beksinska, M., Smit, J. et al. Lubrication and Vaginal Sex: Lubricant Use and Preferences in General Population Women and Women at Risk of HIV. Arch Sex Behav 49, 2103–2116 (2020). https://doi.org/10.1007/s10508-020-01673-3
- Personal lubricant use
- Dry sex
- Microbicide studies
- Sexual practices
- Vaginal sex