The spermicide nonoxynol-9 does not prevent women becoming infected with sexually transmitted infections, and when used very frequently has been shown to cause open genital sores (which may theoretically increase the chance of acquiring sexually transmitted HIV infection).
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Wprowadzenie
There is a need for female-controlled methods of HIV prevention. Vaginal microbicides, substances inserted into the vagina to prevent women acquiring HIV and sexually transmitted infections (STIs) from men, could be useful in this regard. One potential vaginal microbicide is the widely used spermicide, nonoxynol-9 (N-9).
Cele
To determine the safety and effectiveness of N-9 in preventing vaginal acquisition of HIV infection by women from men.
Metody wyszukiwania badań
Extensive searches of electronic databases, conference abstracts, reference lists of relevant studies and contact with experts and funders.
Kryteria doboru badań
Randomised controlled trials meeting pre-determined quality criteria with HIV infection as the outcome.
Zbieranie i analiza danych
Data were extracted by one reviewer and checked by the another. Any discrepancies were adjudicated by a third reviewer.
Główne wyniki
Five trials were included in the review and four contributed to a meta-analysis. Overall, the risk of HIV infection was not statistically significantly different among women receiving N-9 (relative risk [RR] 1.12, 95% CI 0.88-1.42; p=0.4). The risk of genital lesions was statistically significantly greater among women receiving N-9 (RR 1.18, 95%CI 1.02-1.36; p=0.02).
Wnioski autorów
There is no evidence that nonoxynol-9 protects against vaginal acquisition of HIV infection by women from men. There is evidence that it may do harm by increasing the frequency of genital lesions.
