CDC letter on nonoxynol-9 (N-9)

[Barry]

As a result of a study presented in July at the International AIDS Conference in South Africa, the CDC sent out a "Dear Colleague" letter on August 4 warning against the use of condoms with N-9. Clearly, when purchasing condoms, avoid those with N-9. Here is part of the letter for your information. Dr. DG.....anything to add?

 

" This study suggests that the use of N-9 for HIV prevention may be harmful. Second, anyone currently using N-9 as a microbicide to protect themselves from HIV transmission during anal intercourse should be informed of the ineffectiveness of this agent and warned of the potential risk of this practice.

 

CDC has never recommended N-9 alone for HIV prevention, but current recommendations do emphasize the consistent and correct use of condoms, with or without a spermicide. While the level of N-9 used as a lubricant in condoms is much lower than the level found to be harmful in this study, CDC will re-evaluate this guidance as part of the upcoming consultation. In the interim, while N-9 will not offer any additional protection against HIV, a condom lubricated with N-9 is clearly better than using no condom at all. The protection provided by the condom against HIV far outweighs the potential risk of N-9. If given the choice, condoms without N-9 may be a better option for HIV prevention.

 

From a research perspective, these findings point to the need for accelerated efforts to identify a safe and effective microbicide. Of the more than 7,000 new HIV infections occurring in the world each day, about 90% are the result of heterosexual transmission. In addition, more than 330 million new cases of other STDs, such as gonorrhea, chlamydia, and syphilis, occur each year."

[+ honcho]

In the interim awaiting Dr. G's elucidation, It's worth saying that an article discussing this appeared in the San Francisco Bay Area Reporter about 6 months ago. It appears that when Non. 9 is used, the lining of the rectum (the "epithelial" cells) come off in microscopic sheets, thus making it potentially easier for HIV to invade.

[Guest Dr. DG]

The recent observations on nonoxynol-9 (N9) have prompted me to discourage use of condoms that have this additive in their lubricants. The N9 apparently causes mucosal damage and irritation that actually may enhance the transmissibility of HIV and other STD pathogens. I still STRICTLY advocate condom and lubricant use, but no longer say to seek the N9 lubricated products.

 

Many of the men I knew who used N9 lubricated products have developed hypersensitivity (allergies), particularly when used repeatedly over a cycle of a few months to years. Many men also tried these N9 lubricated condoms during oral sex and found the substance to be highly irritating to their mouth and throat. Numbness in the penis and throat has also been reported sporadically.

 

My new recommendations are as follows:

 

1. Use a condom that fits you.

2. Use lubrication.

3. Follow the manufacturer's directions.

4. Use them consistently.

5. Follow all other safer sex recommendations.

 

Thanks!

[Guest MikeConway]

I completely agree with the post above, as a former public health worker and safer sex educator (boy arent I in the right industry now!) this is nothing new to me! I remember taking a call from a woman that commented that the lubricated condoms containing N-9 took off her nail polish, which I proceded to test out on one of my co-workers, And sure enough it did, stay away from the stuff. I can think of many places I DONT want nailpolish remover, neverming the risk of infections from stds!!!!