Washington Blade Online, September 11, 1998
Lisa Keen

Now, in the August issue of the journal Contraception, it appears its use may actually increase the risk of spreading herpes and other sexually transmitted diseases when used in conjunction with anal intercourse.

The study, from the Center for Biomedical Research in New York, involved mice, not humans. But the researchers found that pre-treating the rectums of mice with nonoxynol-9 (dubbed "N9") before then exposing the mice to the herpes virus via the rectum resulted in herpes infection within four days.

The researchers noted that Gay men "commonly report that they use N9-containing condoms, N9-containing sexual lubricants, or spermicides during rectal intercourse." The study with mice was carried out to determine what effect N9 might have in disease prevention during anal intercourse.

"The results," noted the researchers, "were sobering."

"[O]ne would expect that the findings could be generalized to other sexually transmitted pathogens such as HIV," wrote the researchers. "In the case of HIV, transmission rates might be anticipated to increase" because the principal target cells for HIV are present in the lining of the rectum and "become more numerous after tissue damage" as often occurs with anal intercourse.

"Until definitive answers concerning the effect of N9-containing products on the human [rectal lining] are available," concluded the researchers, "it is suggested that the prudent course is to avoid the use of N9-containing products during rectal intercourse when there is a risk" of a sexually transmitted infection.

Stimulating immune system triggers infections?

Although most patients who begin taking combination therapy experience fewer opportunistic infections, doctors in Australia last month reported on patients who they believe developed infections because they started combination therapy.

In the Aug. 20 issue of the medical journal AIDS, doctors at a hospital in Queensland reported that they had three patients who developed cryptococcal meningitis within one to six weeks of starting combination therapy. The patients were all considered "late-stage" HIV infection, with CD4 counts below 50. The doctors noted that there have been recent reports of patients developing other infections, such as cytomegalovirus retinitis, within a few weeks of starting therapy, too. The patients seemed to develop the infections in response to improvements in their immune systems.

The Australian doctors say their study suggests the combination therapies "enhanced immune function and unmasked latent infection" in the patients.

"We predict that patients with advanced HIV disease à are the individuals most at risk of having a sufficient burden of latent opportunistic pathogens to stimulate" the development of an immune response to the pathogens once the immune system begins to recover.

In brief

A POOL OF CAUTION: A report in the September issue of Journal of Infectious Diseases warns that men with HIV infection and fewer than 100 CD4 cells are at increased risk of developing the parasitic infection known as intestinal microsporidiosis if they frequent swimming pools or engage in sexual activity with another man. The study, by a researcher from Paris, noted that the infections appear to be spread through the fecal-oral route, whether waterborne or sexual. The infections cause diarrhea and can lead to wasting and no treatment is currently effective. The report also noted that "swimming in pools, reservoirs, or other bodies of surface water is a well-known source of infection for cryptosporidiosis, giardiasis, shigellosis à and hepatitis."

NEW CMV TREATMENT: The Food and Drug Administration gave a California pharmaceutical company approval Aug. 26 to market its injectable drug for treatment of cytomegalovirus retinitis in patients with AIDS who are intolerant or unresponsive to currently available treatments. The drug fomivirsen sodium was developed by the Isis Pharmaceutical company and will be marketed by the CIBA Vision company under the trade name Vitravene Injection. The standard for treatment is either daily intravenous administration of ganciclovir or foscarnet into the blood system or a ganciclovir implant into the eye. Vitravene is injected into the eye daily for 15 days then monthly but is believed to have fewer side effects.

INSURANCE GUIDE: The National Association of People With AIDS is offering a free brochure on how the 1996 Health Insurance Portability and Accountability Act affects people with HIV. Among other things, it describes the federal lawÆs provisions to preventing health plans from discriminating against people with HIV. For a copy, write NAPWA at 1413 K St. NW, Washington, DC 20005.
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WB980901

Always watch for outdated information. This article first appeared in 1998. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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