Nonoxynol-9 for preventing vaginal acquisition of HIV infection by women from men

Nonoxynol-9 does not protect women against acquisition of HIV infection through sex. There is evidence that it may do harm by increasing the frequency of genital lesions. Based on the current evidence nonoxynol-9 use cannot be promoted for HIV/AIDS prevention programmes in any country.

RHL Commentary by Nandi Siegfried

EVIDENCE SUMMARY

This review—based on five randomized controlled trials— found that nonoxynol-9, a vaginal microbicide, does not prevent women from acquiring HIV vaginally from men. The risk of occurrence of genital lesions, such as ulcers, was higher (relative risk [RR]: 1.18; 95% confidence interval [CI]: 1.02–1.36) in women using nonoxynol-9, being marginally statistically significant.

The authors conducted an extensive search of a wide variety of appropriate databases. They attempted to include both published and unpublished studies by searching conference databases and contacting researchers and funding agencies working in the field. However, the reporting of results of the search could be improved by stating the number of abstracts retrieved and the degree of overlap between the databases. The process of data extraction seems to have been conducted rigorously in a bid to reduce errors.

The full RHL commentary also includes sections on:

Relevance
- Magnitude of the problem
- Applicability of results
- Implementation of the intervention
Research
References

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This document should be cited as: Nandi Siegfried. Nonoxynol-9 for preventing vaginal acquisition of HIV infection by women from men: RHL commentary (last revised: 25 Septmber 2003). The WHO Reproductive Health Library, No 9, Update Software Ltd, Oxford, 2006. www.rhlibrary.com