HIV infections / preventative medicine: condoms / spermicide agents
Merino, G.; Murrieta, S.; Sandoval, C.
Advances in Contraceptive Delivery Systems Cds 10(3-4): 387-389
1994
ISSN/ISBN: 1012-8689 PMID: 12287846 Document Number: 285416
HIV is in the semen and epididymal epithelia. A possible malfunction of the physiological barriers in the seminiferous epithelium may be an early response to HIV. Tight bonds between Sertoli cells serving as the blood-testis barrier may be the site of the breakdown that permits circulating HIV to penetrate the seminal compartment. Receptive partners of anogenital intercourse are more susceptible to HIV infection and progression to AIDS because some metabolites of semen extend to the vascular/lymphatic system. As couples move closer to stage IV of HIV infection, infertility is more likely. Condom use during all sexual encounters outside of long term monogamous relationships is advocated, even if other contraceptives are used. The US government requires strict quality controls on the manufacture of condoms to eliminate condom failure during correct use. HIV cannot penetrate an intact latex condom, thus it prevents the spread of HIV. Not everyone accepts condoms. Laboratory tests show that various spermicidal compounds destroy HIV and other sexually transmitted disease organisms. Yet, epidemiologic studies do not show that spermicides alone can protect against HIV transmission. Either intracellular location of HIV protects it from spermicides, or the toxicity of the spermicide causes genital ulcers which facilitate HIV transmission. An increase in condom sales in the US has occurred, particularly in the states with the highest AIDS rates (California and New York). Condoms made of lamb cecum are an option to men who are allergic to latex. Spermicides can also cause allergic reactions. Physicians should not prescribe the pill to prostitutes who reject condom use. Future research should examine HIV receptor on T lymphocyte, sperm, and brain neurons; local immunity against sperm antigen; development of locally enhanced immune response within the genital tract lumen; and purification/identification of immunosuppressive substances in seminal plasma.