I would like to commend The Daily Collegian for your recent article on the spermicide nonoxynol-9, and associate concerns about its use. It is important for students to be well-informed about issues affecting their health. For many years, this chemical has been promoted as a highly effective birth control agent (as an ingredient in contraceptives such as foams, creams, gels, inserts, and on condoms), which kills sperm, and can also be effective in reducing the incidence of certain sexually transmitted disease organisms such as chlamydia and gonorrhea. Some clarification is perhaps needed surrouding potential problems with the use of nonoxynol-9 where individuals are at risk for the transmission of HIV, the virus which causes AIDS.

Because of the potentially harsh nature of the chemical nonoxynol-9, irritation to the sensitive vaginal or urethral tissues can result for some individuals. (This possibility varies with the amount of the chemical contained in any given product.) This irritation can create a portal of entry for HIV. Should the individual be exposed to the blood, semen or vaginal fluids of an infected person, this scenario would certainly increase one's risk for contracting HIV.

Part of the difficulty with this issue comes in separating out risk factors and behaviors of any given individual or couple. If a sexually active couple has been exclusively monogamous (never had other partners) and clearly has no risk for HIV, but desires to use effective birth control and cannot use oral contraceptives, then condoms and spermicides together (provided neither partner has a reaction to the spermicide) can indeed be highly effective. The gray area comes in where individuals have had a history of unprotected intercourse with several different partners, which places them at risk for HIV and a variety of other STDs, as well as pregnancy. Then, the consistent use of latex condoms (without nonoxynol-9) and/or latex squares for use with mouth to genital contact, is the single most effective barrier against the transmission of HIV and other STDs, apart from abstinence or alternatives to intercourse.

If spermicides are used, individuals should be alert for tender, red areas. If irritation develops, avoid intercourse until healed, and see a health care provider for help with healing. Consider other methods of sexual health protection such as latex condoms.

The Penn State HIV/AIDS/STD Education Consortium, along with University Health Services and other community groups, is committed to educating students, faculty and staff about these issues. Individuals who have further questions, or who would like to become a part of the Consortium's "Ask Me About AIDS" Network, can contact us at 863-0461.