The Austin Chronicle

About AIDS

By Sandy Bartlett, October 18, 2002, Columns

Nonoxynol-9 doesn't prevent HIV or STDs!

Ever have a topic that acts like a vampire? It keeps rising from the dead-issues file to bite once again? I feel that way about Nonoxynol-9, or N9.

N9 is an effective spermicide for birth control, widely used in vaginal foams, sex lubricants, and lubed condoms. Early in the AIDS epidemic, researchers speculated that it might kill HIV in the vagina and help prevent HIV transmission, so safe sex advocates suggested its use as a kind of back-up measure in condom use, pending additional data.

However, subsequent reports indicated that among many users N9 caused allergic irritation that might actually facilitate HIV/STD transmission, rather than stop it. ASA and most AIDS organizations dropped N9 around 1991 and advised against its use in disease prevention. Some portion of the public, though, doesn't seem to have heard that message.

Recently published research has again confirmed the irritation problems associated with N9, and some activists and AIDS organizations are clamoring for an outright end to N9 production. I personally believe that is overreaction. Nonoxynol-9 has a valid, clinically appropriate use: birth control. Why ban an effective option in family planning just because some individuals might use the product inappropriately?

This is a matter of "public relations" in its most useful sense:

Manufacturers who use N9 need to promote awareness among consumers regarding the spermicide's potential drawbacks, whether through better labeling or specific media attention, not unlike warnings about alcohol and pregnancy.

Meanwhile, the largest condom makers have already stopped, or are considering stopping, the use of N9. KY-Plus has been pulled from production, and other lube manufacturers will probably do the same.

The take-home message: Nonoxynol-9 is useful in birth control but it does nothing to prevent disease. It may even make catching a STD easier. Use appropriately and with caution.

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