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02073 LUBRICANTS CONTAINING N-9 MAY ENHANCE RECTAL TRANSMISSION OF HIV AND OTHER STIS. Phillips, David* It has been shown that men who have sex with men seek lubricants that contain nonoxynol-9 (N-9) because they believe that N-9 may help to prevent infection by HIV. However, there is indirect evidence to suggesting that N-9 may actually enhance infection. A clinical study was undertaken to determine whether N-9 causes sloughing of the rectal epithelium and if epithelium repair rapidly following application of N-9. Biopsies and rectal lavages were used to determine if application of the 2% N-9 product K-Y®Plus caused sloughing of the rectal epithelium. To ensure consistency and compliance all procedures for the study were carried out by a clinical investigator. Lavage and biopsy specimens were collected at 15 min and 2 hr post-rectal use of K-Y®Plus in addition to a later time point. Specimens were fixed in buffered glutaraldehyde and embedded in plastic and stained. Blinded slides were examined by light microscopy. Pronounced sloughing was observed in rectal lavage and biopsy specimens collected at 15 min post application of K-Y®Plus. Sloughing was not observed in specimens collected at 2 hrs or 8 hrs post application K-Y®Plus and appeared similar to baseline specimens. Since rectal epithelium protects target cells in the submucosa from HIV; we conclude that lubricants containing N-9 should be avoided during rectal sex. David Phillips |
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