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condoms and lotions - problem ingredients?
Jul 13, 2007

Dear Dr. Bob,

First I have to tell you I love reading your answers you tell it like it is with wit and charm.

I recently was looking at the Q&A on the site about use of lotions with condoms. I read that hand lotions except those that are water or glycerin based make latex condoms ineffective against HIV transmission but I have not found more specific information.

I am HIV positive with an undetectable viral load. In the past I always used KY as a condom lube for active anal intercourse. Unfortunately I now I live in a developing country where KY is not available and I started using Nivea body lotion thinking than only petroleum jelly was a danger to condom integrity. Now reading about lotions I am horribly concerned (actually devastated) about the lotion I am using and having put my casual (f-buddy) partner at greater risk and he does not know I am positive!!! He has never asked and I have never told him. Otherwise I have been extremely careful about 100% condom usage (proper fit, no slippage, no breakage) and besides kissing, we rarely do anything else like oral sex or anal-oral contact (me active).

The product I have been using is Nivea Body lotion and its primary ingredient is water followed by liquid paraffin, isopropyl palmitate, glycerin and alcohol cetearyl. I have also used a few times Oil of Olay Complete which is 100% oil and PABA free but the other ingredients are not listed on the bottle or web site.

Are there statistics on condom usage and transmission with such ingredients? What are the ingredients that cause a problem with latex condoms? Is it just a risk of breakage or also resulting permeability for transmission of HIV?

I am sure that my partner is not very knowledgeable about HIV to begin with so I want to give him as much information as possible.

Secondly Is there updated information on the below that indicates undetectable viral load and unprotected sex has a much lower likelihood of transmission?... http://www.thebody.com/Forums/AIDS/SafeSex/Archive/PreventionSexual/Q139828.html 6) Your partner's viral load (the level of virus in blood) may have an effect on transmission. In many HIV infected people, the use of antiviral medications greatly reduces the viral load in blood. Recent reports out of the XIII International AIDS Conference in South Africa give some information on viral load and it's role in sexual transmission. Studies of mixed-status heterosexual couples (serodiscordant) in Uganda showed that when serum viral load was less than 3500 copies/mL, transmission rate was 0.9 per 1,000 episodes of intercourse. The rates increase when serum viral load was greater than 50,000 copies/mL (2.98 per 1,000 episodes of intercourse). Translation: viral load does affect likelihood of sexual transmission (heterosexual intercourse, not oral sex). More studies need to be conducted.

Sorry for the long message but I have got to know as much as possible!

Response from Dr. Frascino

Hello,

1. Latex condoms and oil-based products (baby oil, petroleum jelly, Vaseline, massage oil, body lotion, cooking oils etc.) do not mix, because they weaken latex, increasing the likelihood the condom will fail. You can read much more about this in the archives, as we've addressed this topic countless times.

2. Yes, additional research continues to show suppressing the HIV plasma viral load does decrease the risk of HIV transmission; however, it does not completely eliminate the risk. Consequently, safer sex techniques (latex or polyurethane condoms) remain an essential.

Dr. Bob



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