Nonoxynol-9 May Increase HIV Transmission Risk

Nonoxynol-9 (N-9), a spermicide found in many sexual lubricants and on many lubricated condoms, may not be the HIV-prevention panacea many had hoped.

Regular use of products containing N-9 may increase the risk of HIV transmission. Since the mid-1980s, many lube and condom manufacturers were promoting N-9 as a possible microbicide against HIV and other sexually transmitted diseases, when it was found to have some "limited effect" in killing HIV and other viruses and bacteria in test tubes and lab animals.

N-9 was developed as a spermicide and does a decent job at killing sperm, which means basically lowering the risk of an unwanted pregnancy. It was not developed with the intent to kill HIV or any other virus or bacteria and has never been approved by the Food and Drug Administration for this purpose.

Although N-9 did have a limited ability to kill HIV in the laboratory, in human studies N-9 was found to strip away the outer layer of skin inside the vagina and the rectum. HIV that wasn't killed entered the bloodstream more easily, thereby increasing the risk of HIV transmission by as much as 50 percent when compared to using a water-based lubricant without N-9. Because of this, the Centers for Disease Control and Prevention has advised against the use of N-9 as a microbicide. Of course, a condom lubricated with N-9 is better protection than no condom at all.

Several microbicides being tested are hoped to decrease the risk of HIV and STD transmission, but none of these are yet approved or available for use. Microbicides that do become available will still be recommended for use in conjunction with a latex or polyurethane condom.

John Kirby is a health promotion specialist in AIDS Project Los Angeles' POWER program. He can be reached by calling (213) 201-1558 or by e-mail at jkirby@apla.org.