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Nonoxynol 9
Nov 13, 2000

You recently stated that using a condom with N-9 is "probably" better than not using a condom at all? Did I misread? Are you saying that if I have been using condoms with N-9 (which at one point was highly recommended), I was not sufficiently protected????

Response from Mr. Kull

Probably might not have been the best word to use there. I'm going to take that out. How about this: using a condom with N-9 on it is better than not using a condom at all.

Let me include what Helene Gayle, Director of the National Center for HIV, STD, and TB Prevention recommends about Nonoxynol-9:

"This study was conducted among women at very high risk C commercial sex workers C who used a great deal of the product on a frequent basis. The adverse effects might not be seen at the same level among women who are using spermicides with N-9 less frequently or in different formulations. However, given that N-9 has now been proven ineffective against HIV transmission, the possibility of risk, with no benefit, indicates that N-9 should not be recommended as an effective means of HIV prevention.

With the release of these data, the scientific evidence on N-9 as an HIV prevention strategy is now conclusive and significant. As a result, prevention guidelines must be re-evaluated. UNAIDS and CDC will be holding consultations over the next few months to consider official revisions to public health guidelines for the use of N-9 for HIV prevention and for pregnancy prevention in populations at high risk for HIV. In the interim, these findings have several immediate implications.

First, any community delivering hierarchical prevention messages that counsel individuals who can’t use a condom to consider spermicides with N-9 for HIV prevention should immediately revise these messages. This study suggests that the use of N-9 for HIV prevention may be harmful. Second, anyone currently using N-9 as a microbicide to protect themselves from HIV transmission during anal intercourse should be informed of the ineffectiveness of this agent and warned of the potential risk of this practice.

CDC has never recommended N-9 alone for HIV prevention, but current recommendations do emphasize the consistent and correct use of condoms, with or without a spermicide. While the level of N-9 used as a lubricant in condoms is much lower than the level found to be harmful in this study, CDC will re-evaluate this guidance as part of the upcoming consultation. In the interim, while N-9 will not offer any additional protection against HIV, a condom lubricated with N-9 is clearly better than using no condom at all. The protection provided by the condom against HIV far outweighs the potential risk of N-9. If given the choice, condoms without N-9 may be a better option for HIV prevention."

Hopefully this helps.

RMK



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