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Nonoxinol 9 for women with undetectable viral load
Jul 23, 2005

Hi Dr. Bob, Youre my star because whenever I feel depressed over being HIV+ I read in your archives and have a good chuckle. Thank you! I hope my question gets your attention. I checked your archives, but there is nothing there that relates exactly to this issue. Im a woman with an undetectable viral load, and a partner who loses his erection 30 seconds after he puts on a condom. However Im not going to get into the old stale question about whether I can have sex without a condom with a negative man. All Im asking is : could someone please confirm that HIV+ women with undetectable viral loads can have unprotected sex with a negative partner they trust using Nonoxinol 9 and assure him of a zero risk? It seems so obvious because all the objections about Nonoxinol 9 are about eating up your insides and making you more susceptible to being infected. I dont care about that! The issue is about protecting my man, not myself. Plus losing his erection by definition is a definite bummer! Nonoxynol 9 does kill HIV in vitro, so its got to wipe out whatever persists in the vaginal fluid of a woman with an undetectable viralload. Can you confirm this please? Thanks so much!

Response from Dr. Frascino


You would like me to "confirm that HIV+ women with undetectable viral loads can have unprotected sex with a negative partner they trust using nonoxynol-9 and assure him of a zero risk???" Sorry my dear, no can do! We do not have any clinical trial data that would support that claim. What nonoxynol-9 does in the test tube cannot be extrapolated to what it may do in the love canal. I would strongly advise against the assumption that nonoxynol-9 offers zero risk in this situation. In fact, I believe there is older data on n-9 trials that support my concerns.

So what to do? Condom use can take some getting used to. Problems range from decreased sensation to performance anxiety. The vast majority of these issues can be sorted out via a medical examination and some counseling regarding technique. If there is an issue of "erectile dysfunction," as the TV adds like to describe it, perhaps baby blue Viagra could be your "quicker pecker upper."

Stay safe. Stay well.

Dr. Bob

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