On September 27 over 80 health experts and organizations released a letter warning against all rectal use of nonoxynol-9 (N-9) -- a spermicide mistakenly used to kill HIV, when actually it makes transmission worse. The letter came after a quiet campaign that persuaded most but not all manufacturers to remove the substance from their products. Experts agree that rectal use is dangerous and never appropriate -- and that N-9 should not be included in any condoms or lubricant.

On October 10 the Bay Area Reporter, a San Francisco gay newspaper, reported that all lubricant manufacturers had now promised to stop making lubricant with N-9. This followed an earlier series of articles in the B.A.R. that prompted some local retailers to remove N-9 products from their shelves.

From the September 27 consensus letter:

"Call to Discontinue Nonoxynol-9 for Rectal Use

"We, the undersigned, in light of recent statements by the World Health Organization and the Centers for Disease Control, urge all people to cease the rectal use of products containing Nonoxynol-9 (N-9). We are concerned that many people mistakenly believe that N-9 provides extra protection against HIV and STDs when used rectally when in fact there is reason to think that rectal use of N-9 may increase risk of infection.

"The Centers for Disease Control states: 'N-9 can damage the cells lining the rectum, thus providing a portal of entry for HIV and other sexually transmissible agents. Therefore, N-9 should not be used as a microbicide or lubricant during anal sex.'

"The World Health Organization states: 'N-9 should not be used rectally.' (Further) 'There is no published scientific evidence that N-9-lubricated condoms provide any additional protection against pregnancy or STIs compared with condoms lubricated with other products.

"'Since adverse effects due to the addition of N-9 to condoms cannot be excluded, such condoms should no longer be promoted.'"

For More Information

• On September 25 The Wall Street Journal published "Some Makers, Venders Drop N-9 Spermicide on HIV Risk."

• The World Health Organization consensus report is at: www.who.int/reproductive-health/rtis/nonoxynol9.html.

• And on September 28, 2002, The Lancet formally published results of a major study in Africa that showed that N-9 could increase HIV transmission -- available at www.thelancet.com (free registration required).

ISSN # 1052-4207

Copyright 2002 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used.

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