Nonoxynol-9 Not Effective in Preventing HIV Transmission, WHO/CONRAD Report Says

The chemical nonoxynol-9, which is found in at least 18 over-the-counter spermicides sold worldwide, does not reduce the spread of HIV as once thought and could increase the likelihood of HIV transmission, according to a joint report released last week by the World Health Organization and Eastern Virginia Medical School's Contraceptive Research and Development Program, the Norfolk Virginian-Pilot reports. The report, which contains the recommendations of a meeting of experts convened last October, says that nonoxynol-9 -- which is found in some gels, creams, foams, sponges and lubricated condoms -- disrupted the vaginal lining in 18% of women who used it every other day and in 53% of women who used it at least four times a day. As a result, frequent use of nonoxynol-9 facilitated infection by sexually transmitted disease-causing viruses and bacteria and did not "inactivat[e]" the organisms as previously thought. The spermicide increased the risk of HIV infection during both vaginal and anal sex, the report says (Szabo, Norfolk Virginian-Pilot, 6/26). The researchers also determined that nonoxynol-9 is not effective in preventing cervical gonorrhea or chlamydia (Higgins, Associated Press, 6/28).

Recommendations
The report concludes that "[w]omen who have multiple daily acts of intercourse should be advised to choose [a] method of contraception" other than nonoxynol-9 (Reuters, 6/28). However, the spermicide remains effective at preventing pregnancy, the report states, and is safe for use by women who are not injection drug users and who are in monogamous relationships. The researchers noted that "it is better to use a nonoxynol-9 lubricated condom that no condom." Dr. Henry Gabelnick, director of CONRAD, said that about 11% of American women of reproductive age use contraceptives containing spermicides (Norfolk Virginian-Pilot, 6/26). WHO officials said Friday that researchers should "work urgently on developing a microbe-killing chemical" that is effective against HIV (Associated Press, 6/28). The full report is available online.