Cannabis, cognition, and residual confounding.

the results of this study and the knowledge gained from more than a decade of randomized trials of non-oxynol-9 as a vaginal microbicide, it is time to move on. Women at risk for STIs such as chlamydia and gonorrhea are often also at risk for HIV-1. In practical terms, a vaginal microbicide must have no risk of increasing HIV-1 incidence before it can be introduced as a microbicide for other STIs. Given its poor safety profile in frequent users, non-oxynol-9 is clearly not that product. Despite more than 15 years of urgent appeals for an effective vaginal microbicide for prevention of HIV-1 and other STIs, few clinical trials of microbicides have been published. In contrast , several studies of mother-to-child transmission of HIV-1 have published results that have had a dramatic effect on reducing perinatal HIV-1 transmission rates. Whatever the reasons for this difference, during the past 5 years, while research on vaginal microbicides has inched forward, more than 10 million women worldwide have acquired HIV-1, the vast majority of whom live in the developing world. 17 Although the message that nonoxynol-9 is not an effective vaginal microbicide is disappointing, it should not discourage further microbicide research. Clearly, there remains a need for an inexpensive, effective, female-controlled method for preventing STIs, and there may be many studies with negative results before one is found. Research on other vaginal microbicides, conducted by individual investigators as well as by research networks, should be encouraged. 18 The study by Roddy et al can serve as an example of a well-designed and executed trial that has moved the field of microbicide research another step forward. The cat/ feline immunodeficiency virus model for transmucosal transmission of AIDS: non-oxynol-9 contraceptive jelly blocks transmission by an infected cell inoculum. Reducing the risk of Chlamydia trachomatis genital tract infection by evaluating the prophylactic potential of vaginally applied chemicals. Effects of nonoxynol-9 on vaginal microflora and chlamydial infection in a monkey model. Effect of the contraceptive sponge on chlamydial infection, gonorrhea, and candidiasis: a comparative clinical trial. A clinical trial of non-oxynol-9 for preventing gonococcal and chlamydial infections. A controlled trial of nonoxynol 9-film to reduce male-to-female transmission of sexually transmitted diseases. Evaluation of a low-dose non-oxynol-9 gel for the prevention of sexually transmitted diseases. The effect of non-oxynol-9 gel on urogenital gonorrhea and chlamydial infection: a randomized controlled trial. I N THIS ISSUE OF THE JOURNAL, SOLOWIJ AND …