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Nov 8, 2000

Hi, I am an HIV educator and have recently received a questioned about spermicides that I do not know the answer to. I know that non-oxynol 9 is not a good product for all people to use due to allergic reactions. What about other spermicides?? Do other spermicides cause the same allergic reactions that non-oxynol 9 can??? What is Advantage-S?? Thank you..:)

Response from Mr. Kull

The jury is still out on the effectiveness of spermicides, like nonoxynol-9 (N-9), in preventing HIV transmission. The Centers for Disease Control is currently reviewing its recommendations for spermicide use in HIV prevention. The allergic reaction that some people have to N-9 may increase a person's risk for HIV infection when having sex with an HIV infected person. Any kind of irritation of mucosal membranes (the lining of the vagina, rectum, and urethra) can facilitate HIV infection.

For now, the CDC suggests that N-9 should not be recommended as an effective means of HIV prevention. I am not aware of any other effectiveness studies of other types of spermicides or recommendations for their use.

Advantage-S is the gel containing nonoxynol-9 that was used in the studies of African sex workers. HIV-negative commercial sex workers who used this gel during sexual intercourse had a 50% higher rate of HIV infection than those who used a placebo gel. While sexual activity and amount of gel used is probably higher than the average population, it seems that N-9 probably offers no considerable benefit in HIV prevention.

Until more information about other spermicides is available, I would suggest that you recommend the following to your population:

1) Always use a condom for vaginal and anal sex.

2) Do not use nonoxynol-9 without condoms as a means of disease prevention.

3) If possible, use unlubricated condoms with a gel/lubricant that does not contain spermicides. Lubricated condoms sometimes contain detergents that cause irritation.

4) Using a condom with N-9 on it is better than not using a condom at all.


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