Gay Men Not Heeding Warnings About Spermicide

A considerable percentage of men who have sex with men do not know that the spermicide nonoxynol-9 offers no protection against HIV infection and could even enhance transmission, according to a recently released study. In fall 2001, researchers from CDC's Division of HIV/AIDS Prevention interviewed 573 homosexual and bisexual men in the streets of the San Francisco Bay area aiming to see if the men had absorbed warnings issued since 2000 by CDC and the World Health Organization that N-9 should not be used during anal intercourse. Studies have shown that N-9, a spermicide contained in some condoms and lubricants, offers no STD protection and destroys the protective lining of the rectum, which could allow HIV to be more easily transmitted.

Overall, 61 percent, or 349, of the 573 men interviewed had heard of the spermicide. Just more than half of the 349 had heard that it might not protect against HIV. Of the men who knew about N-9, 83 percent had used it, of which 67 percent had used it for anal intercourse in the previous year. Of those who used it during anal sex, 41 percent did so without using a condom because they thought it would protect them against HIV transmission, the study, "Rectal Use of Nonoxynol-9 Among Gay Men Who Have Sex with Men," reported in the April 11th issue of the journal AIDS (2003;17(6):905-909). "So even though they were hearing the message, it wasn't translating into behavioral change," said lead author Dr. Gordon Mansergh, a senior behavioral scientist at CDC.

The study aimed to evenly sample races, ages, education and income. Twenty-nine percent were Latino, 28 percent were African American, 28 percent were Caucasian, and 15 percent were other. The ages ranged from 18 to 67, and 50 percent were HIV-negative, 38 percent were HIV-positive, and 12 percent had an unknown status.

Of those interviewed, African Americans were more likely to say they would use N-9 during anal intercourse. Those with unknown HIV status and Latinos were less likely to have heard of N-9 and therefore more likely to have unknowingly used it, said Mansergh. Although gay mens' understanding may have changed since the study was conducted, the results demonstrate that public health officials should be more targeted with their messages, particularly when the message changes, Mansergh said.

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