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lemon and lime juice as potential microbicides: questions and cautions
Megan Gottemoeller, Global Campaign for Microbicides
You may have
heard that lemon and limejuice are potential microbicides.
There is a lot
of public discussion about this possibility but not a lot of factual
public information. In a climate where everyone urgently wants new
ways to prevent HIV, it is sometimes hard to sort out facts from
we DO know:
- Women in
many cultures have used lemon or limejuice for contraception and
hygiene purposes for centuries
- Citrus juice
is acidic. The pH of a healthy vagina is acidic, except when semen
is present. An acidic environment kills sperm and many disease
pathogens, including HIV. The semen raises the vaginal pH temporarily
to help sperm survive.
- Some scientists
have suggested that using lemon or limejuice vaginally could reduce
the risk of HIV transmission by keeping the vagina acidic even
in the presence of semen. Any product capable of doing that without
damaging the vagina would be a contraceptive microbicide.
- Studies with
monkeys have not shown negative side effects of limejuice on vaginal
- Phase 1 safety
studies are being conducted in California and Virginia (USA) to
determine whether using limejuice vaginally is safe for healthy
women at low risk of HIV.
data suggests that, at the same concentrations, lemon juice may
be significantly less effective than lime juice in killing HIV
in test tube cultures.
we DON'T Know:
- Does lemon
or limejuice affect the cells of the human vaginal lining, causing
disruptions or irritations that can enhance HIV transmission?
- Does lemon
or limejuice induce an inflammatory response that could enhance
- Does lemon
or limejuice negatively affect the naturally occurring micro-organisms
that keep the vagina healthy and resistant to infections?
- How much
lemon or limejuice is safe to use, and how frequently?
- Does lemon
or limejuice actually work to prevent HIV transmission in human
beings? What concentration is necessary to be effective?
Until we know
the answers to the questions above, our messages about lemon and
limejuice as potential microbicides must reflect caution. Otherwise,
we risk misleading people who may use lemon or limejuice for prevention,
when it could have no effect or be harmful.
- We desperately
need an effective, affordable, and accessible microbicide. But
the only way we can know if a product is really safe and effective
is by doing ethically conducted trials. Until the trial data are
collected and analysed, we can only guess whether a product works
- Just because
a product is "natural" rather than chemically manufactured does
not automatically mean it is safe, or safe at all dosages or for
all people. We must conduct scientifically rigorous research specifically
designed to answer these questions.
the lesson of N-9. Early data suggested that it was safe for women
to use and we knew it killed HIV in a test tube. Trial data in
2000, however, showed that N-9 was not effective in reducing HIV
risk. In fact, using it more than once a day may actually increase
HIV risk slightly by irritating the vaginal membranes and making
it easier for the virus to enter the blood stream.
- We cannot
recommend that people use any product for prevention of HIV until
it has been proven through research to be safe and effective.
Lemon and lime juice have not yet passed that test.
For more information
about microbicides, microbicides research, ethics and advocacy,
please visit: www.global-campaign.org
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