San Francisco Examiner - September 26, 2002
Angelina Malhotra-Singh Of The Examiner Staff

Public health officials have been warning the public for years about the risks of nonoxynol-9, but somehow the public has largely missed out on the news.

Killer condoms and lethal lubricants containing nonoxynol-9 (N-9) continue to be widely available, and consumer awareness of the danger presented by the spermicide is practically nonexistent. And that's true even within the gay community, a particularly high-risk group that is usually well informed about the latest in HIV prevention.

"Treatment activists have known N-9 is killing people for quite a while," says Michael Lauro of Survive AIDS. "But the overall knowledge base is low."

The World Health Organization recently released yet another report on N-9, one emphatically stating that using sexual aids and condoms containing the spermicide could increase the risk of HIV infection. The Centers for Disease Control and Prevention has released similar reports.

In the wake of the WHO study, Supervisor Mark Leno last week called for a citywide ban against the sale of all sexual lubricants containing N-9, calling the lubricants "a catalyst for (HIV) infection ... a danger to public health."

The problem is the Department of Public Health doesn't agree.

"The data (from the WHO study and a previous CDC study) is not conclusive.

The tests were not done on men. For us to ban it outright would require a lot more specific research," explains Steven Tierney, DPH's HIV prevention director.

Nationwide, scientists, public-health advocates and a slew of women's and gay-rights groups are poised to launch a series of public awareness campaigns.

But Tierney says he's unwilling to launch a similar sort of educational crusade, the kind that Lauro and Dr. Tom Coates would like to see.

"It is new news to a lot of people, and if it were more widely known there might be pressure on the manufacturers (from consumers) to stop making products with N-9," says Coates, head of HIV prevention studies at UCSF.

There is little incentive for the companies to step up to the plate -- N-9-treated product lines account for about 40 percent of the $295 million U.S. condom market alone. In fact, lubricant and condom packaging fail to mention any health risks associated with N-9, and popular condoms such as Trojan-ENZ still claim use of the product "may help reduce the risk" of catching or spreading AIDS.

"As a person with AIDS, while I commend Leno's initiative, we shouldn't need a local supervisor to advocate basic health issues. DPH is asleep at the switch, which is very disturbing," Lauro said.

And while Tierney maintains that his department requires "clearer evidence" in order to make a decision based in "fairness and science" -- particularly since N-9 is still considered an effective pregnancy-prevention product -- activists fear that between the manufacturers' bottom-line mentality and The City DPH's prove-it-to-us attitude, the opportunity to boot N-9 out will once again be lost.

"This product is pushed and marketed in gay-centric neighborhoods. How many gay pregnant men are walking around the Castro?" asks Lauro. "How many people have to die before enough 'evidence' is in?"

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