Intervention Review

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

  1. David Wilkinson1,*,
  2. Gita Ramjee2,
  3. Maya Tholandi3,
  4. George W Rutherford4

Editorial Group: Cochrane HIV/AIDS Group

Published Online: 17 MAR 2010

Assessed as up-to-date: 7 MAY 2002

DOI: 10.1002/14651858.CD003936

Database Title

Additional Information

How to Cite

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 3. Art. No.: CD003936. DOI: 10.1002/14651858.CD003936.

Author Information

  1. 1

    University of Queensland, School of Medicine, Brisbane, Queensland, Australia

  2. 2

    Medical Research Council, HIV Prevention Research Unit, Durban, KwaZulu-Natal, South Africa

  3. 3

    California Department of Health Services, HIV/AIDS Epidemiology Branch, Office of AIDS, Sacramento, California, USA

  4. 4

    University of California, San Francisco, Global Health Sciences, San Francisco, California, USA

*David Wilkinson, School of Medicine, University of Queensland, Brisbane, Queensland, Australia. david.wilkinson@uq.edu.au.

Publication History

  1. Publication Status: Stable (no update expected for reasons given in 'What's new')
  2. Published Online: 17 MAR 2010

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

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).

Objectives

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

Search methods

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

Selection criteria

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

Data collection and analysis

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

Main results

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).

Authors' conclusions

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.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

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).

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

Nonoxynol9 在預防人類免疫缺乏病毒經陰道由男性傳染到女性的功效

由女性方面來控制人類免疫缺乏病毒的感染是有其必要性的.考量到這一點,陰道內殺菌劑,一種置入陰道內的物質,用以避免婦女感染人類免疫缺乏病毒或是性傳染病,可能會是有效的.其中的一種陰道內殺菌劑,被廣泛的使用來殺死精蟲就是 nonoxynol9 (N9).

目標

為了探討N9在阻止人類免疫缺乏病毒,經陰道由男性傳染到女性,的安全性和效果.

搜尋策略

我們廣泛尋找電子資料庫、會議摘要、相關的研究參考目錄並聯絡專家與出資者。

選擇標準

隨機對照試驗符合事先決定的標準,以是否被HIV感染作為結果。

資料收集與分析

資料由一個審查者解讀，並由另一審查者複檢。其中的歧見由第三個審查者裁決。

主要結論

在這次的回顧性分析中包涵了五次試驗,其中四個試驗有做統合性分析。整體而言, HIV感染風險在婦女接受N9 治療後,並未有顯著的統計學差異(相對風險[RR] 1.12, 95% 信賴區間 0.88 – 1.42; p = 0.4) 。在接受N9的婦女之中生殖道的病灶發生機會則是有統計學意義的增加(RR 1.18, 95%CI 1.02 – 1.36; p = 0.02) 。

作者結論

沒有證據可以證明nonoxynol9 有防止人類免疫缺乏病毒經陰道自男性傳染到女性的功效。證據證明它可能會造成生殖道的傷害且增加生殖道病灶的發生頻率。

翻譯人

本摘要由臺北榮民總醫院藍鴻杰翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

殺精劑 nonoxynol9 不但無法預防婦女因為性行為得到性傳染病,反而,在高使用頻率的狀況下,還容易造成生殖道的傷口(這樣的傷口,在理論上會增加HIV感染的機會)

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