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non-oxynol 9
Oct 26, 2002

hey dr. i really appreciate all your work that you are doing in this site. it has helped me a lot to alleviate my fears. yet i have to ask you this. about 2 weeks ago, i had protected sex with a call girl. her status was unknown to me but she was real strict in a sence i couldnt kiss her mouth and everthing had to be with a condom on. well...i had vaginal intercourse with her protected...maybe for a minute...then i got off and changed the condoms and had sex with her again for a minute...my only worry is that my condom had non oxynol 9 in it and i heard it could deactivate hiv. but in your responses you say non oxynol 9 increasexs the chances to get hiv. and thats whats scared me. i was wondering at what risk am i in to get hiv? i thought i was practically at a negligable risk because the condom didn't break and also since non oxynol 9 is both inside and outside the condom...it should further reduce my risk...i dont know...pls alleviate my fears...i am considereing to take a p24 test...thank you

Response from Mr. Kull

Nonoxynol-9 is only likely to increase your risk for infection if you are exposed to HIV infected fluids. Even then, the increase in risk isn't all that significant based on one exposure and with the small amount that would be present on a condom. The real issue for the majority of people is that nonoxynol-9 offers no real benefit, so it's better to just avoid using it.

Laboratory studies have shown that the spermicide nonoxynol-9 does kill HIV. For some time prevention messages have included the use of lubricants with spermicide to prevent the transmission of HIV. However, recent developments in transmission research have changed this recommendation.

Spermicides like N-9 can be irritate the mucous membranes (lining of the vagina, rectum, and urethra). This allergic reaction that some people have to N-9 might increase a person's risk for HIV infection when having sex with an HIV infected person. Any kind of irritation of mucosal membranes can facilitate HIV infection.

Advantage-S is the gel containing nonoxynol-9 that was used in the studies of African sex workers. HIV-negative female 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.

Here's some recommendations for future sexual activity:

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.

5) Your best bet is using a condom and lube for sex. There are no condoms or lube that are known to kill HIV, besided spermicides. More research is being conducted on microbicides so that people have more options in the future.

RMK



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