Inactivation of HTLV-Iii/Lav-Infected Cultures of Normal Human Lymphocytes by Nonoxynol-9 in Vitro

Hicks, DonaldR.; Martin, Linda S.; Getchell, JaneP.; Heath, JanetL.; Francis, DonaldP.; McDougal, J S; Curran, J. W.; Voeller, Bruce

doi:10.1016/s0140-6736(85)92584-x

Cited by 192 publications

(39 citation statements)

References 6 publications

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“…Barrier methods such as the male and female condoms are considered effective tools for prevention of STDs and HIV. In regard to microbicides, the data-and the Food and Drug Administration 27 -have long supported a role for microbicides in STD prevention 28 , and some studies have suggested that nonoxynol-9 is also effective against HIV 29,30 , but there has been concern about biological safety. A study by Kriess et al 31 raised questions as to whether overuse of nonoxynol-9 might have a facilitative effect on HIV transmission.…”

Section: The Theme Of Autonomy: Female-initiated Methodsmentioning

confidence: 99%

Ourselves, our bodies, our realities: an HIV prevention intervention for women with severe mental illness

Collins

Geller²,

Miller³

et al. 2001

Journal of Urban Health: Bulletin of the New York Academy of Medicine

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This paper describes a 10-session behavioral intervention introducing female-initiated methods of human immunodeficiency virus (HIV) prevention to reduce vulnerability to HIV infection for womenThe acquired immunodeficiency syndrome (AIDS) epidemic threatens the lives of women with severe mental illness (SMI).* Recent evidence suggests that AIDS is a leading cause of mortality among young women with psychotic illnesses in suburban New York State; these women acquired AIDS primarily through unsafe sex with HIV-infected men. 1 Rates of human immunodeficiency virus (HIV) infection among women with SMI approach those of men with SMI, greatly exceeding seroprevalence rates among women in the general US population. 2 Prevalence rates ranging from 5% to 9% have been reported among chronically mentally ill women in urban centers. 3,4 Drs. 162 HIV PREVENTION AND WOMEN WITH SMI 163In this article, we present a behavioral intervention for HIV prevention that begins to address the needs of women with SMI, including the need for femaleinitiated barrier methods such as the female condom. This article describes (1) the context of HIV risk for women with SMI, (2) the HIV prevention curriculum "Ourselves, Our Bodies, Our Realities" for women with SMI, and (3) the results of a test of the intervention. THE CONTEXT OF RISKBehaviors that place women with SMI at risk for HIV infection include sex in exchange for money or goods, substance abuse, multiple sexual partners, sex with partners who use injection drugs, and inconsistent use of condoms. 5-9 Long-term institutionalization does not protect these women entirely from sexual encounters and their inherent risk as sexual intercourse without condom use continues to occur in some institutional settings. 10 Yet, these individual behaviors occur in a larger context that is essential to note. Among the contextual factors that influence the ability of women to reduce their risk of HIV infection, we highlight three: economic dependence, sexual violence, and the impact of severe and persistent psychiatric illness, such as schizophrenia, on cognitive functioning. Economic DependenceMost women with SMI living in urban environments are poverty-stricken. A severe and persistent mental illness all but ensures limited employment opportunity and economic dependence on government subsidies, family members, or partners. 11 For impoverished women with SMI, concerns for survival and financial stability may conflict with opportunities for risk-free sexuality.Economic disadvantage carries the complexities of dependency. Women often depend on male partners for economic support of children, for shelter, and for food. Partnerships may emerge with the understanding that a woman and her children will be provided for in exchange for a sexual relationship. In such arrangements, women with SMI may not have the freedom to prioritize their safety in sexual relationships above material needs. Weinhardt et al. 12 report that women with SMI rated poverty and employment as greater life priorities than HIV ...

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Section: The Theme Of Autonomy: Female-initiated Methodsmentioning

confidence: 99%

Ourselves, our bodies, our realities: an HIV prevention intervention for women with severe mental illness

Collins

Geller²,

Miller³

et al. 2001

Journal of Urban Health: Bulletin of the New York Academy of Medicine

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“…To draw from pregnancy as a surrogate end point, we converted the Pearl index, as reported in contraception studies, into the probability of sperm moving through the barrier (i.e., up the uterus) under a binomial model.32 On the basis of several assumptions-(I) 75% to 90% fertile couples,22 (2) 2 to 4 fecund days per cycle, (3) 98% to 100% compliance during fecund days, (4) a probability of .35 to .50 for a successful implantation during an unprotected contact on a fecund day, and (5) data from a subsequent Cameroon study, in the presence of 90% self-reported condom use,'5 a sample of at least 10 000 women would be required to identify a 50% risk reduction per contact due to spermicide use. This sample size was computed assuming (1) heterogeneity and misclassification in condom use (45% "consistent" users, 50% "less consistent" users, and 5% "liars" with sporadic use at prestudy level6 reporting "consistent" use; details not shown), (2) submultiplicative efficacy of the combined methods (see Table 3), and (3) We addressed a possible higher risk among partners where both methods were used. A higher prevalence by a factor of two alone would explain the findings (Table 3) lihood approaches, however, suggested the absence of major confounding factors (e.g., that a higher prevalence among partners where both methods were used influenced our results and that women using more spermicides had fewer contacts) and the robustness of estimates against deviations from model assumptions.…”

Section: Discussionmentioning

confidence: 99%

The protective effect of condoms and nonoxynol-9 against HIV infection.

Wittkowski

Süsser²,

Dietz³

1998

Am J Public Health

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OBJECTIVES: Whether or not spermicides can reduce the risk of human immunodeficiency virus (HIV) transmission remains an important question for the control of heterosexual HIV transmission. The authors provide estimates from a reanalysis of one of the few observational studies on the efficacy of condoms and spermicides, used separately and together, per vaginal contact. METHODS: In this reanalysis, three different models were used to assess the efficacy of spermicides and condoms: linear (Pearl index), exponential (maximum likelihood), and monotonic (marginal likelihood). RESULTS: Reported use of barrier methods among 27,432 contacts was as follows: condoms plus nonoxynol-9, 39%; condoms alone, 25%; nonoxynol-9 alone, 24%; and unprotected, 11%. Under all three models, the results indicate a strong protective effect for spermicidal suppositories. The Pearl index indicated that spermicide alone is apparently efficacious, but the efficacy per contact cannot be quantified with this approach. Maximum likelihood estimates for the efficacy of nonoxynol-9 alone and condoms (with or without nonoxynol-9) were 100% (95% confidence interval [CI95] = 43%, 100%) and 92% (95% CI95 = 79%, 100%), respectively. CONCLUSIONS: The data from this observational study suggest that spermicides may be efficacious in reducing the risk of HIV transmission.

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“…It has been an aim of the microbicide field for over 20 years when overthe-counter (OTC) spermicides were shown to possess activity against STIs [19] and subsequently activity against HIV [20]. However, initial clinical studies evaluating OTC spermicides as potential microbicides had mixed results [21][22][23][24] and were eventually abandoned with the disappointing results from the COL-1492 study, showing that the OTC spermicide nonoxynol-9 (N-9) could be toxic to the vaginal tissue thereby increasing the risk of HIV infection [25].…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetic study to compare the absorption and tolerability of two doses of levonorgestrel following single vaginal administration of levonorgestrel in Carraguard® gel: a new formulation for “dual protection” contraception

et al. 2007

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Objective: The study was conducted to assess levonorgestrel (LNG) serum levels achieved after a single administration of two different doses of Carraguard vaginal gel containing LNG (CARRA/ LNG), designed for use as microbicide and contraceptive for potential dual-protection. Materials and methods:This was a randomized double-blind pharmacokinetic study conducted in 12 subjects enrolled at two centers. Each subject received a single vaginal administration of CARRA/LNG containing either 0.75 or 1.5 mg LNG per 4 mL of gel on day 10-12 of the menstrual cycle. LNG serum levels were measured at 0, 1, 2, 4, 8 and 12 h after administration and for the following seven days. LH and progesterone (for a preliminary evaluation of effect on the ovarian function) as well as SHBG were measured in the daily samples.Results: Serum LNG maximum concentrations (C max ) were 14.1 ± 5.1 and 11.7 ± 6.5 nmol/L and T max was 12.0 and 6.0 h for the low and high dose, respectively, with large intersubject variability within the first 48 h. Mean levels at 96 h were 10% of C max . Differences in AUC between both doses were not statistically significant. SHBG levels decreased approximately 25% by day 4 after administration. Luteal activity was observed in 3/6 and 5/6 of the subjects in the low and high dose group, respectively. Conclusion:This study demonstrates that the CARRA/LNG gel can sustain elevated serum levels of the contraceptive steroid for up to 96 h after a single application. The serum levels attained with the 0.75 mg formulation are in the range expected to perturb the ovulatory process as observed in some subjects. The lack of correlation between the administered dose and serum concentrations of the steroid may be related to a rate-limiting absorption of LNG from the vaginal mucosa. The results reported here suggest that the CARRA/LNG formulation has good potential to become a dualprotection method, possibly preventing conception and sexually transmitted infections.

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Inactivation of HTLV-Iii/Lav-Infected Cultures of Normal Human Lymphocytes by Nonoxynol-9 in Vitro

Cited by 192 publications

References 6 publications

Ourselves, our bodies, our realities: an HIV prevention intervention for women with severe mental illness

Ourselves, our bodies, our realities: an HIV prevention intervention for women with severe mental illness

The protective effect of condoms and nonoxynol-9 against HIV infection.

Pharmacokinetic study to compare the absorption and tolerability of two doses of levonorgestrel following single vaginal administration of levonorgestrel in Carraguard® gel: a new formulation for “dual protection” contraception

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