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VLI's TODAY SPONGE GONORRHEA PREVENTION RATE OF 69%

Executive Summary

VLI's TODAY SPONGE GONORRHEA PREVENTION RATE OF 69% was shown in a study conducted by Family Health International (FHI), and presented at a press conference held by the research association on April 30 in Washington, DC. In the first phase of the study, "among the sponge users there were 69% fewer infections with gonorrhea," than among non-sponge users, according to the principal investigator Michael Rosenberg, MD, former FHI Director of Reproductive Epidemiology Division, and now American Social Health Association Executive Director. The study was published in the May 1 issue of the Journal of the American Medical Association (JAMA). The trial investigated the protective effects of the spermicide nonoxynol 9-containing sponge against gonorrhea and chlamydia, the two most common sexually transmitted diseases in the U.S. Conducted in Bangkok, Thailand between June and August 1986, the study involved a high risk population of 312 sexually active women. They had a 15% chance per week of becoming infected, the study said. The average age of the women was 23 years, most were childless and most used oral or injectable steroid contraception. The women were randomized into a sponge user group of 149 and a non-user group of 163. During the trial's first phase, the parallel cohort, the women were checked weekly for disease over six weeks. Those who were disease-free were allowed to continue into the second phase of the study or the crossover cohort, which lasted for another six weeks. One hundred nine women continued into the crossover cohort and were placed in the alternate treatment group. The study reported that "chlamydial infection proved to be the most frequent outcome studied with a total of 99 infections, but the risk of infection was lower among sponge users in the parallel cohort." The estimate of women infected was "29% for sponge users and 51% for nonusers." Rosenberg said there were "33% fewer infections of chlamydia among the women using the sponge." In addition, he noted that sponge users in the parallel cohort had an "estimate of infection of 8% compared with 40% among women not using the sponge." However, "as compared with nonusers, sponge users had approximately two and a half times the rate of candidiasis," the study observed. According to the study, the increased risk of candidal infections among sponge users may be explained by "a greater bacterial sensitivity to nonoxynol 9 as compared with fungi, allowing candidal over-growth similar to that seen in cases where broad-spectrum antibiotics are employed." The consistency of results for the crossover cohort "reinforces the finding of protection against chlamydia, increased risk for candida, and, to a lesser extent, protection against gonorrhea," the study stated. According to the report, the sponge's contraceptive action is based on three properties that "may also affect its actions on the pathogens . . . in addition to the 1 gm of nonoxynol 9 in each sponge, its porosity traps the sperm, which may carry pathogens, and placement over the cervix provides a physical barrier." The study noted that in light of these and other findings "couples might even consider the use of spermicides as a means of infection prophylaxis independent of their pregnancy prophylaxis." Laboratory tests indicate that nonoxynol 9 inhibits a variety of sexual transmitted organisms including those that cause "gonorrhea, chlamydial infection, candidiasis, genital herpes, syphilis, trichomoniasis, and the acquired immunodeficiency syndrome," the study added. Commenting on nonoxynol 9, FHI president Malcolm Potts remarked, "we have no information to date as to whether it has any effect on the transmission of AIDS infection." A representative from the National Institutes of Health (NIH) announced that NIH is currently conducting a U.S. study on contraceptive sponges similiar to the FHI trials.
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