SPERMICIDE WORSENS HIV RISK, STUDY FINDS
By Maggie Fox
Reuters 12 July 2000
South Africa -- Researchers hoping to find a way for women
to protect themselves from AIDS have said they were dismayed to find that a
product they thought may prevent infection actually increased the risk.
The product, a spermicide called nonoxynol-9, did not protect prostitutes
in Benin, Ivory Coast, Thailand and South Africa from infection with HIV, a
team of U.N.-sponsored researchers said.
"We were dismayed to find out that the group using the N-9 gel had a
higher rate of HIV infection than the group using a placebo,'' Dr Joseph
Perriens, who heads the UNAIDS microbicide effort, told an AIDS conference
They tested nearly 1,000 women and found 59 of those who used the
spermicide became infected with HIV, compared to 41 of those who used a
"We were extremely disappointed,'' Lut van Damme, a researcher at the
Institute of Tropical Medicine in Antwerp who led the study, told a news
She said researchers may be forced to suspend other trials involving the
product, marketed under the trade name Advantage S by U.S.-based Columbia
"The long-term safety of nonoxynol-9 as a family planning method may have
to be re-evaluated,'' she said.
Activists and researchers have been clamoring for the development of a
microbicide -- a gel or cream sometimes described as an "invisible
condom'' -- that women and men could use to protect themselves not only
from HIV, but from other sexually transmitted diseases such as syphilis and
"I think this may be the end of nonoxynol-9 as a potential microbicide,''
Van Damme said, although she said the trials did show that women -- in this
case prostitutes at high risk of HIV infection -- would use a microbicide
if one was available.
CDC Expresses Concern
The Centers for Disease Control and Prevention (CDC) said it was concerned
by the findings because some groups advise people to use nonoxynol-9 to
protect themselves from HIV if they cannot use a condom.
"I think it's pretty clear we have to tell men who have sex with men not
to use it,'' Dr. Lynn Paxton, a microbicides expert at the CDC, said in an
"I think they are most at risk and I know they are using it.'' She said it
was less clear whether women who use nonoxynol-9 as a contraceptive --
women who are not at risk of getting HIV -- should avoid it.
One possible reason for the findings was that the women who used the
spermicide had more lesions than the women who did not, Van Damme said.
"If you use nonoxynol-9 (to protect from HIV), you are probably wasting
your money. You may possibly be wasting your life,'' Perriens said. But, he
added: "There is nothing in this trial to suggest you should stop using it
as a spermicide.''
UNAIDS said it was pressing for the development of other products.
"We know that there are more products to come,'' Perriens said. "This
shouldn't be the end of the field... One of the things holding up
development, increasingly, is a lack of private sector interest in this
The Bill and Melinda Gates Foundation said it would try to help with a $25
million grant for microbicide research.