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

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).

研究背景

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).

研究目的

To determine the safety and effectiveness of N-9 in preventing vaginal acquisition of HIV infection by women from men.

检索策略

Extensive searches of electronic databases, conference abstracts, reference lists of relevant studies and contact with experts and funders.

纳入排除标准

Randomised controlled trials meeting pre-determined quality criteria with HIV infection as the outcome.

资料收集与分析

Data were extracted by one reviewer and checked by the another. Any discrepancies were adjudicated by a third reviewer.

主要结果

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).

作者结论

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.

引用文献
Wilkinson D, Ramjee G, Tholandi M, Rutherford GW. Nonoxynol-9 for preventing vaginal acquisition of HIV infection by women from men. Cochrane Database of Systematic Reviews 2002, Issue 4. Art. No.: CD003936. DOI: 10.1002/14651858.CD003936.

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