Global Campaign for Microbicides, 2002
Talking Points on “Call to Discontinue N-9 for Rectal Use?
Why have we issued (signed) the Call to Discontinue N-9 for Rectal Use?
We are concerned that individuals are seeking out lubricants and condoms containing Nonoxynol-9 under the mistaken belief that it offers them added protection against HIV and STDs when if fact it may be increasing their risk of infection.
We are especially concerned about individuals who are using N-9 containing products rectally. Even very small doses of N-9 have been shown to cause massive, short-term disruption and shedding of the cells lining the rectum, leading to increased risk of HIV infection.
N-9 has been used in vaginal contraceptive products for over 50 years. Manufacturers began adding it to condoms and lubricants in the mid-1980s when early research suggested that it might offer some protection against HIV.
New research has shown definitively that N-9 does not prevent HIV or STD transmission. Both WHO and CDC have issued guidance cautioning against rectal use of N-9 and saying that N-9 should not be recommended for HIV prevention.
Scientists, public health officials, industry and activists all have an obligation to act when new data become available that challenge past beliefs about the safety and effectiveness of existing drugs like nonoxynol-9.
By acting now, we can save lives.
What, exactly, are we calling for?
We are calling upon all manufacturers of condoms and sexual lubricants that contain nonoxynol-9 to stop adding N-9 to their products.
We are calling for retail outlets to discontinue stocking these products.
We are calling on the public health establishment, service providers and advocates to use every means at their disposal to get the message to consumers that N-9 does not help prevent HIV or STDS and should NOT be used rectally.
We are calling for re-doubled efforts to develop products that can be used safely and effectively in both the vagina and rectum to help prevent AIDS. Scientists are confident that such products—know generically as microbicides-- can be developed. But N-9 is not one of them.
Who are we and why is this initiative significant?
We represent a coalition of over 85 organizations and researchers from the public health, family planning, AIDS and women’s health communities
The Call is being spearheading by the Global Campaign for Microbicides, based in Washington D.C.
Endorsers include: amfAR, Gay & Lesbian Medical Association; National Women’s Health Network, Planned Parenthood, National AIDS Trust, UK, Aids Action, Gay Men’s Health Crisis. (See “Call” for complete list)
What have we accomplished thus far?
In June, organizers of the Call began negotiating with lubricant and condom companies to encourage their voluntary removal of N-9 from future lots of their products.
Several companies have agreed to discontinue/phase out the N-9 versions of their products. Among these are:
Mayer Laboratories, distributor of Aqua Lube Plus, Kimono Condoms, and Maxx Condoms
Planned Parenthood, which distributes its own Planned Parenthood Condom
Johnson & Johnson has agreed to discontinue adding N-9 to the condoms it manufactures in Brazil. They also discontinued their KY Plus lubricant in July.
Trimensa, makers of For Play Plus; Bcummings Co., makers of Elbow Grease, and Westridge Laboratories, makers of ID-Glide Plus
The 3 largest condom manufacturers –makers of Trojans, Durex and Lifestyle—condoms have refused to remove N-9 from their products.
Why aren’t we calling for the removal of vaginal contraceptives containing N-9?
Contraceptives foams and crèmes designed specifically for vaginal use remain an important contraceptive option for women who are at low risk of HIV infection or other STDs. These include: Conceptrol®, Delfen®, Ortho-Gynol, Encare®, VCF®, Semicid®, Advanatage®, and Koromex®.
N-9 is considerably more toxic at low doses when used in the rectum than the vagina.
Why not just label on condoms and lubricants for vaginal use only?
Labeling is a weak response to a public health emergency. The belief that N-9 helps is deeply entrenched and it will take much more than a euphemistic label to eliminate this risk.
Wouldn’t removing N-9 from condoms and lubricants deprive women of an important form of backup protection against pregnancy?
The amount of N-9 in sexual lubricants is not sufficient to provide any meaningful protection against pregnancy.
While it has been widely believed that N-9 lubrication on condoms provides a “back-up” should the condom slip off or break, there is no research that proves that N-9 lubricated condoms are more effective at either contraception or STI protection than condoms with silicone oil lubricant or water-based lubricants.
If used consistently and correctly, condoms alone provide an excellent form of pregnancy protection.
For more information see: Click on the Box entitled, “N-9 Call and Info.”
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