teflonian

I recently heard about the failure of nonoxynol-9 in recent studies and wondered what exactly that meant. In search of information I found this website which seems to be a decent balanced source of information. So, yes nonoxynol-9 did fail to live up to its hopes and it may in fact be a cause of some problems. However, with out regular use it doesn't seem that anyone has to throw out anything with this in it or be worried about past use of this spermicide. Anyway, didn't see any other threads mentioning this and thought I would share... Enjoy. If anyone has any additional info or comments, they would be much appreciated.


http://abcnews.go.com/sections/livin...es_030214.html


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Spermicides and Condoms: Not the Best Marriage?

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By Peggy Crane
It is a well-known fact that consistent and correct use of condoms can prevent pregnancy. But condoms are not perfect. They've been known to break on occasion, and people don't always use them correctly. That's why doctors have recommended that they be used in conjunction with an over-the-counter spermicide for extra birth-control insurance.

But say the word "condom" and what comes to mind more often is its reputation as the method of choice for practicing safe sex. Condoms are now primarily used to prevent many sexually transmitted diseases, including HIV, the virus that causes AIDS.

In the late 1980s, nonoxynol-9, a product that has been on the market for more than 50 years and the main ingredient in most spermicides, began to show promise as a method for preventing HIV transmission when it was observed to kill the virus in a test tube. The public and the medical community alike hailed N-9 as the newest HIV preventative, and many condom manufacturers hastened to lubricate their products with the chemical.

Unfortunately, hopes were dashed when more recent studies — including a four-year World Health Organization study of HIV-negative female sex workers in Africa and Thailand — showed N-9 to be ineffective in the prevention of HIV infection. In fact, researchers discovered that when used frequently, products containing N-9 may even increase the risk of acquiring the virus.

Understanding what N-9 can and cannot do can be daunting, much less making the right choices regarding its use. Below, Rowena Johnston, Ph.D., Associate Director of Basic Research at the American Foundation for AIDS Research (amfAR), shares the latest findings about N-9 and stresses correct condom use as still the best defense against HIV transmission for men and women alike.

Are condoms a foolproof method of HIV prevention?
If everybody used them all the time, condoms would do a good job of slowing down transmission. The problem is that people don't use condoms all the time. People often feel uncomfortable insisting on the use of a condom with their partner. We really need products that don't require a partner's consent. That way, we'd feel free to protect ourselves and take charge of our own health.

Many people think they are at low risk for HIV, so why take the trouble to use a condom?
Some women may think of themselves as fairly low-risk and therefore might not insist on the use of condoms. But that's a serious mistake. There are straight men out there, too, who don't think they need to protect themselves from infection because they still think HIV is a "gay" disease.

Why don't people use condoms more consistently when this simple device is obviously the key to safe sex?
I think what we're seeing now is kind of a fatigue. People have been aware that they should be practicing safe sex since the 1980s. And our sense is that people are kind of getting sick of being good all the time. You know, it's as if you're on a diet and sometimes you want to eat chocolate. But that's precisely why you should stick with the diet.

How does Nonoxynol-9 work against HIV?
HIV is a virus that has a fatty membrane around it, just like our own cells have. Nonoxynol-9 is essentially a detergent. Detergents cut through grease, and that's exactly how N-9 kills HIV and other sexually transmitted infections. But it only does the job in a test tube. What we found in this study was that once you put N-9 in a woman's vagina, it will also cut through the fat of her cells, which makes it easier for HIV to get into those cells. Women who are highly exposed to N-9 actually show ulceration on the tissues of the vagina, and those ulcers can enhance the ability of HIV to get in. The same holds true for men. The rectum is even more vulnerable than the vagina to the effects of N-9.

Many experts still recommend N-9 as a contraceptive for women at low risk for contracting HIV. Do you agree with that?
I think if a woman is not using N-9 very often, there probably is a low risk of ulceration. It's not a perfect birth control method anyway, of course. But I really think that people should be using condoms all the time to make sure that they're safe.

There are a lot of condoms produced today that contain N-9. In light of recent findings, is this likely to change?
There has been a move to urge condom makers to take N-9 out of their condoms. Studies have shown that if you're using a condom correctly, the additional protection you get from N-9 in terms of preventing pregnancy is negligible, plus you're running the risk of increasing the transmission of HIV. We feel that adding N-9 isn't worth it, given the risks involved.

What is the state of HIV infection in the United States today?
We estimate that there are about a million people infected in the United States, of which only about two thirds know that they're infected. The number of new infections each year has remained quite stable for the last four or five years, at about 40,000 new infections each year. The thing is, the proportion of those who are women is rising precipitously. And the proportion of those who are African American is also rising, so a disproportionate share of the new infections are occurring in women, African Americans and Latinos.

Do we know why?
That's a really tricky question. Our prevention messages may not be working equally well in every community. Obviously, we need renewed efforts, new ways of tackling the problem, and new ways of communicating with diverse ethnic and age groups.

Do you think that the failure of N-9 to produce positive results will dampen hopes for a product that really works against HIV?
I hope not. After all, we had a promising product, we tested it, and we learned that nonoxynol-9 doesn't work. We also learned why, which means that we learned what we shouldn't be trying in the future. Now we have a better idea of what we should be looking at. Researchers are looking at different classes of chemicals that could disable HIV in completely different ways while leaving the vaginal and rectal lining intact.
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