Nonoxynol-9 in Lubricated Condoms

BACKGROUND AND OBJECTIVES: Debate continues on the efficacy and safety of intravaginal nonoxynol-9 for the prevention of horizontal transmission of human immunodeficiency and other sexually transmitted diseases. Little attention has been paid to the effects of nonoxynol-9 contained in the lubricant of many condoms. GOAL: To assess the tolerability of different levels of nonoxynol-9 in condom lubricants. STUDY DESIGN: Pilot, randomized, controlled trial in 70 female prostitutes. RESULTS: There was no association between dose of nonoxynol-9 and reported symptoms or signs of genital tract inflammation; an increased dose of nonoxynol-9 was associated with increased numbers of polymorphonuclear leukocytes on a vaginal wall smear. CONCLUSIONS: There is no recognized simple method of defining inflammation in the female genital tract. Future studies of the effects of low-dose nonoxynol-9 on the female genital tract require highly controlled exposures, plus colposcopy with or without vaginal biopsy to define inflammation.