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HIV and AIDS HIV and AIDS Basics

Spermicides and Condoms: Not the Best Marriage?


Medically Reviewed On: February 12, 2003

By Peggy Crane

It is a well-known fact that consistent and correct use of condoms can prevent pregnancy. But condoms are not perfect. They've been known to break on occasion, and people don't always use them correctly. That's why doctors have recommended that they be used in conjunction with an over-the-counter spermicide for extra birth-control insurance.

But say the word "condom" and what comes to mind more often is its reputation as the method of choice for practicing safe sex. Condoms are now primarily used to prevent many sexually transmitted diseases, including HIV, the virus that causes AIDS.

In the late 1980s, nonoxynol-9, a product that has been on the market for more than 50 years and is the main ingredient in most spermicides, began to show promise as a method for preventing HIV transmission when it was observed to kill the virus in a test tube. The public and the medical community alike hailed N-9 as the newest HIV preventative, and many condom manufacturers hastened to lubricate their products with the chemical.

Unfortunately, hopes were dashed when more recent studies — including a four-year World Health Organization study of HIV-negative female sex workers in Africa and Thailand — showed N-9 to be ineffective in the prevention of HIV infection. In fact, researchers discovered that when used frequently, products containing N-9 may even increase the risk of acquiring the virus.

Understanding what N-9 can and cannot do can be daunting, much less making the right choices regarding its use. Below, Rowena Johnston, Ph.D., Associate Director of Basic Research at the American Foundation for AIDS Research (amfAR), shares the latest findings about N-9 and stresses correct condom use as still the best defense against HIV transmission for men and women alike.

Are condoms a foolproof method of HIV prevention?
If everybody used them all the time, condoms would do a good job of slowing down transmission. The problem is that people don't use condoms all the time. People often feel uncomfortable insisting on the use of a condom with their partner. We really need products that don't require a partner's consent. That way, we'd feel free to protect ourselves and take charge of our own health.

Many people think they are at low risk for HIV, so why take the trouble to use a condom?
Some women may think of themselves as fairly low-risk and therefore might not insist on the use of condoms. But that's a serious mistake. There are straight men out there, too, who don't think they need to protect themselves from infection because they still think HIV is a "gay" disease.

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