The most widely used spermicide may not offer the best protection against sexually transmitted diseases. Instead, new research data concludes, the active ingredient in only one contraceptive jelly marketed in the United States and another chemical not in any American product were the most effective in tests against diseases such as herpes, chlamydia, gonorrhea and AIDS.
The UCLA research identifies octoxynol-9, the chemical used in Ortho-Gynol Contraceptive Jelly, and benzalkonium chloride, used in Europe but not here, as superior to the most common ingredient, nonoxynol-9, that is present in such products as Gynol II, Ortho-Creme and the Today contraceptive sponge.
"On balance," the study concluded, "it would appear that octoxynol is the spermicide most effective."
The Ortho Pharmaceutical Corp., the largest manufacturer of spermicides, said it could not respond to the UCLA findings because its choice of ingredients was based entirely on contraceptive effectiveness. Ortho said its product line includes both octoxynol-9 and nonoxynol-9 to offer consumers a choice in the event one ingredient or the other causes side effects.
The spermicide test results, which knowledgeable scientists said would be highly controversial, may pose a problem in fashioning a large-scale AIDS-prevention campaign. Like condoms, spermicides have never been certified by the U.S. Food and Drug Administration for anything but pregnancy prevention. Yet in a variety of public and consumer-oriented forums, Surgeon General C. Everett Koop and other public health officials have urged use of condoms and spermicides containing nonoxynol-9 as an AIDS-prevention technique. Now the UCLA-sponsored tests introduce the possibility that it is not the most effective agent for that purpose.
The report on spermicides was included among hundreds of pages of a federally funded condom research project headquartered at UCLA. The spermicide testing was conducted in 1987, but the report wasn't written until earlier this year.
The results, which had not been publicly released because of a variety of political and scientific intrigues, were obtained by The Times last week under the Freedom of Information Act.
Proposed Spermicide Study
The UCLA researchers initially ordered a study of spermicide effectiveness against the AIDS virus and other sexually transmitted diseases as part of a plan for a large human trial of condoms to assess their true ability to prevent AIDS. The study sought to identify the most effective condoms and spermicides on the market so such products could be distributed to research subjects.
The plan was terminated, however, when the federal government's National Institute on Child Health and Human Development withdrew financial support for the project. The institute concluded that such a large-scale human test would be too dangerous to its subjects because the high concentrations of AIDS cases in Southern California, where the research would have been done, would have made the chances of contracting the disease dangerously high if a condom failed.
In an especially controversial finding, the UCLA-sponsored research found that octoxynol-9 alone is also capable of killing the Epstein-Barr virus, linked to the mysterious disease associated with chronic fatigue and other symptoms.
In their report to the government, UCLA researchers also disclosed that laboratory notebooks containing one of two sets of AIDS test data had been mysteriously lost by a laboratory technician working on the study as a UCLA subcontractor. The loss of the data means that the HIV results "should be interpreted with caution," the report concluded. But the report also said a duplicate set of the data had been retained. And the researchers emphasized that the findings on gonorrhea and chlamydia are at odds with reports by other scientific teams, requiring further verification. But the results for other sexually transmitted diseases, the research report noted, were less open to question.
Despite the questions about spermicides and the AIDS virus, the report concluded that if the canceled human trial had been held, "the choice of octoxynol as the spermicide . . . would appear obvious: It is effective against the most agents and it is already FDA-approved."
However, the report also noted there may be "some user opposition" to octoxynol. Scientists familiar with spermicide research said there are tentative and highly controversial studies that suggest the use of octoxynol is associated with an increase in birth defects.
Researchers questioned by The Times, who agreed to comment on the condition they would not be named because they did not want to be drawn into a political or legal controversy, called the birth defect findings preliminary and possibly incorrect. Ortho has mounted vigorous legal defenses for octoxynol's safety.
Benzalkonium, the researchers concluded, would be a good second choice, but the FDA said no American product is authorized to use the chemical widely employed in France and Switzerland. A U.S. drug company, which the researchers did not identify, is believed to be testing benzalkonium for use in a contraceptive sponge.