TREATMENT REVIEW 32 - 33 - Fall/Winter 2000
Nearly 1,000 HIV-negative women in several sites in Africa
enrolled in a study to see if using condoms and a vaginal gel
called nonoxyl-9 or N-9 (known as Advantage-S in the United
States) would prevent HIV transmission during sexual intercourse.
All the women who participated in this study were commercial sex
workers. N-9 is an approved spermicide designed to help prevent
pregnancy. It was hoped that this gel would also prevent the
transmission of some sexually transmitted diseases, including
HIV. According to the Centers for Disease Control and Prevention
(CDC), the N-9 gel definitely does NOT prevent HIV transmission.
Using the N-9 during anal or vaginal intercourse may actually
increase the chances that HIV will be transmitted. Some brands of
lubricated condoms contain N-9. Condom use is still strongly
recommended as a way to prevent HIV transmission, although
condoms that have N-9 should be avoided.
All women in the study were asked to use condoms every time they
had sexual intercourse. In addition, half of the women were asked
to use a vaginal gel that contained N-9. The other half of the
study participants were given a placebo - gel that did not contain
N-9. Women who used the N-9 gel became infected with HIV at a 50%
higher rate than women who used the placebo gel. The more
frequently women used the N-9 gel, the greater their chance of
The CDC states that using N-9 is NOT an effective way to prevent
HIV transmission. Although using a condom that has N-9 is still
much better than not using a condom at all during anal or vaginal
intercourse, the N-9 does not offer any additional protection
against HIV. The CDC also states that, "this study suggests that
the use of N-9 for HIV prevention may be harmful."
As this issue of Treatment Review went to press, the manufacturer
of Wet Lube lubricants announced that they were removing
nonoxyl-9 from all of their products.