Washington DC
HOPES that women may soon be offered a 鈥渃hemical condom鈥� to protect them
from HIV infection have faded.
AIDS researchers believed that women might protect themselves from HIV by
using a common spermicide, nonoxynol-9 (N-9) (This Week, 6 January 1996, p 8).
But American researchers studying 940 Cameroonian prostitutes have found that
women applying a film containing N-9 were just as likely to contract HIV as
those given placebo films without the chemical.
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In the 1980s, scientists discovered that N-9 kills HIV in laboratory tests.
It soon became the leading contender as a 鈥渧aginal viricide鈥� to join condoms,
which are still unpopular in many cultures, in the battle against HIV
infection.
Early trials in Kenya used high doses of N-9, but had to be stopped because
many women in the trial developed vaginal ulcers. The Cameroonian study used
only a fourteenth of the dose given in Kenya because the researchers wanted to
find out whether smaller quantities of N-9 could ward off HIV without irritating
the vagina. But the trial failed on both counts: 42.2 per cent of the women who
used the N-9 film reported genital sores, compared with 33.5 per cent in the
placebo group.
鈥淚t would have been nice to have something that worked right off the bat,鈥�
says Rodney Hoff of the US National Institute of Allergy and Infectious Diseases
near Washington DC, who coordinated the Cameroonian study. However, he notes
that other formulations of N-9, such as gels, might work better.
Other researchers argue that research to develop alternatives to N-9 should
also be a priority. 鈥淎mazingly, little development has occurred,鈥� says Kevin De
Cock of the London School of Hygiene and Tropical Medicine.
