The way it was applied in the studies it almost was 100% effective in preventing pregnancies. During in vitro experiments, neem oil also totally immobilized sperm cells within 20 to 30 seconds of being in contact with neem oil.
It is nothing new... "In the first century B.C., Charaka, the Indian physician, gave a detailed method for using neem for contraception. Cotton soaked in neem oil was kept in the vagina for fifteen minutes before intercourse. This killed the sperm."
Newer studies showed that neem oil contraceptive indeed kills sperm in the vagina within 30 seconds and remains active for five hours. It causes no irritation or discomfort like the chemical based spermicidal foams do. (Apart from the awful smell.)
In addition neem oil acts as a lubricant, and it may also offer some protection from vaginal and sexually transmitted diseases. Neem is well known to be a powerful antimicrobial herb. Neem oil, when applied vaginally, has been shown to be very effective against several sexually transmitted diseases (STD’s). There has been strong evidence found in a number of studies that leads us to believe that neem can be successfully used against gonorrhea, syphilis, Chlamydia, herpes simplex-2 and possibly even HIV-1. Research is underway, and more research is needed to see how neem can be of value in fighting these and other STD’s.
NEEM OIL - USE AS A LUBRICANT
To prevent pregnancy, use a water based vaginal lubricant with ten-percent neem oil added. Apply before intercourse to give the surface of the vaginal wall time to become coated with the material. If there was no neem lubricant available during intercourse applying the lubricant soon sifter inter-course will prevent implantation.
NEEM - CONTRACEPTIVE FOR MEN
Neem leaf tablets ingested for one month produced reversible male antifertility without affecting sperm production or libido (Deshpande, 1980) (Sadre, 1984). In India and the United States, exploratory trials show neem extracts reduced fertility in male monkeys without inhibiting libido or sperm production (Sharma, et al, 1987).
In a test of neem's birth control effects with members of the Indian Army, daily oral doses of several drops of neem seed oil in gelatin capsules were given to twenty married soldiers. The effect took six weeks to become 100 percent effective, it remained effective during the entire year of the trial and was reversed six weeks after the subjects stopped taking the capsules. During this time the men experienced no adverse side effects and retained their normal capabilities and desires. (Vietmeyer, 1992) There were no pregnancies of any of the wives during the period of the study.
For long term birth control for men it appears that a very minute amount of neem oil injected in the vas deferens provides up to eight months of birth control. The tests revealed no obstructions, no change in testosterone production and no anti-sperm antibodies. The local lymph nodes showed increased ability to respond to infections indicating an immune response may be responsible for the birth control effect in men as it is in women. (Upadhyay, 1993).
Truvada is a combination of two drugs: Emtricitabine (FTC) and Tenofovir (TDF). It's mostly used to prevent or lower the risk of HIV infection prior to exposure i.e. Pre-Exposure Prophylaxis (abbreviated as PrEP; contrast this with PEP - Post-Exposure Prophylaxis in current use). So far, in Kenya, studies are ongoing to determine the large scale effectiveness of this drug for preventing HIV infection to people who may be routinely exposed. Primarily the studies are focusing on discordant couples and one of the organizations involved is Partners-in-Prevention somewhere in Thika along with the likes of NASCOP and other regulatory bodies.
As of last year, it has already been demonstrated that FTC+TDF combination is more effective than TDF alone for PrEP, albeit in a small study/sample size. Efforts are now focused on studying if similar results would be reproducible in a larger sample size and once this has been demonstrated we will then thereafter expect national PrEP guidelines to be developed.
As I have mentioned, research is primarily focused on discordant couples at the moment so for us here in Kenya it is unlikely that the drug will be widely available for general use. These drugs are ordinarily expensive and since the same drugs are used in normal HIV/AIDS management, we will obviously restrict availability to prevent misuse and subsequent emergence of resistance.
In the meantime, we have recently updated our national ART clinical guidelines to now require that the HIV +ve partner in a discordant relationship be immediately put on ART regardless of his/her CD4 count.
It is also worth mentioning that PrEP is not a magical bullet but is intended to augment other safe sex practices.