Nonoxynol-9 Spermicide Info

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Nonoxynol-9 could increase danger of HIV transmission, health officials say...

September 28, 2002 - Following an about-face by the world's leading public health agencies on the use of nonoxynol-9 in reducing the risk of HIV transmission, an Oakland-based healthcare company has taken the most aggressive moves yet by any U.S. firm in eliminating the spermicide from its product line and educating pharmacy workers nationwide about its potential hazards. By early 2003, Mayer Laboratories' products lines will have been modified so they no longer contain nonoxynol-9, or N-9, said David Mayer, the company's president. He said his decision, announced Thursday, followed recent studies that showed that even at low levels, N-9 irritated rectal and vaginal tissue enough to create points of entry for HIV, the virus which causes AIDS.

Last week, Mayer also sent out more than a dozen educational packages about the potential risks of N-9 use to major retailers which distribute products containing N-9, like Longs Drug Stores, Walgreens, Rite Aid, Safeway, Albertsons, Wal-Mart, Target, Kmart and Drugstore.com.

When asked why his firm was making such an extensive outreach effort, Mayer responded, "We need to help people know what's going on out there. It's part of our mission and underlying corporate responsibility to be a leader in the area of public health."

The products most worrisome to public health officials are condoms coated with N-9 and personal lubricants containing the spermicide. Suppositories and gels with N-9 don't pose the same risk of increasing HIV transmission.

Lori Heise, director of Global Campaign for Microbicides, a group working to convince manufacturers of condoms and personal lubricants to eliminate the use of N-9 in the products, emphasized that some uses of the spermicide are safe and effective.

"If you're at risk for HIV, you should probably use another form of contraception," she said. "However, if you're a 35-year-old woman in a monogamous relationship using a diaphragm, using nonoxynol-9 is no problem."

The key difference between the two scenarios, she explained, is a person's risk of exposure to HIV.

So far, only Mayer, Planned Parenthood Federation of America, which produces its own condoms, and a subsidiary of Johnson & Johnson, which carried one product containing N-9, are dropping the spermicide in their products.

Producers of the leading lines of the condoms -- Trojan, Durex and Lifestyle -- have "balked" at suggestions that they stop using the spermicide, Heise said.

In the early 1990s, public health officials were excited by studies in the laboratory and in animals which showed N-9 acted as a microbicide, an agent that can kill viruses and bacteria. It was thought that N-9 might become an inexpensive and convenient way to reduce HIV infections.

But later studies in humans showed it could also damage the lining of the vagina and the rectal membrane. The damaged membranes then can't block infectious agents from entering the body.

So while the early studies showing that N-9 was effective in killing viral agents weren't refuted, the later studies showed the damage the spermicide caused to membranes outweighed any viral-killing benefit it provided, Mayer explained.

© Suzanne Bohan for The Oakland Tribune, ANG Newspapers

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