Nonoxynol-9 Position Statement

Canadian Federation for Sexual Health (CFSH) takes the position that Nonoxynol-9 is a spermicide[1] and should be used as such and not as a microbicide or lubricant. Although nonoxynol-9 demonstrated microbicidal potential (the ability to kill pathogens) in the laboratory and in animal tests, this has not been the case during clinical trials. Nonoxynol-9 protects against pregnancy, but it does NOT protect against sexually transmitted infections such as HIV, chlamydia or gonorrhoea. In fact, frequent use of nonoxynol-9 can irritate the lining of the vagina (and the anus if used rectally) and subsequently increase the risk of acquiring a sexually transmitted infection, including HIV.

Sexual and reproductive health will be optimized when health care providers and health educators:

• Inform clients that nonoxynol-9 is a spermicide, not a microbicide, and as such, it should only be used for contraceptive purposes (ie. vaginal intercourse)
• Inform clients that frequent use of nonoxynol-9 (for example, multiple daily acts of intercourse) can irritate the vaginal or anal lining and increase the risk of transmission of HIV, chlamydia and gonorrhoea.
• Encourage clients to evaluate the risks and benefits of using nonoxynol-9 as a contraceptive method.
• Stop distributing condoms and lubricants with nonoxynol-9.
• Inform clients that using a condom with nonoxynol-9 or a lubricant with nonoxynol-9 for anal intercourse irritates the rectum and increases the risk of transmission of HIV.
• Inform clients that using a male or female lubricated condom WITHOUT nonoxynol-9 for vaginal or anal intercourse is the most effective prevention against sexually transmitted infections, including HIV.

Reviewed November 5, 2007 KD



[1] Definition: A spermicide is a detergent (chemical agent) that kills sperm. Nonoxynol-9 is one type of spermicide available.