The diaphragm contraceptive device does not help to prevent HIV infection, according to the results of a three-year trial published in the Lancet today.
Frequent use of sexual lubricants containing the spermicide nonoxonyl-9 (N-9) by women at high risk of contracting HIV, increases the risk of HIV infection, a new study suggests. Nonoxynol-9 is a common ingredient in sexual lubricants, condoms and contraceptive products designed for vaginal use such as diaphragm jelly, contraceptive foams and creams. Despite earlier claims that the spermicide could help prevent HIV transmission, the study found that lubricants containing N-9 did not have a protective effect on HIV transmission in high-risk women. According to a report published in the 28 September issue of the medical journal The Lancet, researchers from the Institute of Tropical Medicine, in Antwer , Belgium and researchers from South Africa, Ivory Coast, Benin and Thailand provided 376 female sex workers with lubricant containing N-9. They gave 389 other female prostitutes sexual lubricant without the spermicide. All of the women were also instructed to use condoms for every sexual act. Overall, the team found that women who reported using lubricant with N-9 about three and a half times a day were nearly twice as likely to be infected with HIV than the women who used the lubricant without spermicide. Nonoxynol-9 no longer has a part to play in HIV-1-prevention. Our data show that low frequency use of nonoxynol-9 causes neither harm nor benefit; but that frequent use increases a woman's risk of HIV-1 infection by causing lesions. The study called for more research on additional prevention methods, such as other female-controlled methods, microbicides, and vaccines. Meanwhile, the Global Campaign for Microbicides last week called for the removal of the spermicide from condoms and lubricants. WHO report acknowledges the increased risk of HIV infection when N-9 is used frequently by women at high risk of infection, but stated that it remains a contraceptive option for women at low risk. There is no evidence that condoms lubricated with nonoxynol-9 are any more effective in preventing pregnancy or infection than condoms lubricated with silicone, and such condoms should no longer be promoted. (Source: PLUSNEWS Johannesburg, 1 October 2002).