Since the beginning of the HIV epidemic, gay men have been advised to use condoms consistently to reduce the chance of HIV transmission during anal intercourse. In Western Europe the use of thicker condoms for anal sex has been advocated, though there is no evidence of their greater efficacy from human studies.
Yesterday at the International AIDS Conference in Durban, researchers from City University in London released data from a double-blind randomised controlled trial involving 283 gay couples who had been using either thicker or standard condoms for anal sex.
Each couple was randomly allocated 9 thicker or standard condoms and water based lubricant. Each couple completed a questionnnaire immediately after using each of the condoms.
Condom failure was defined as breakage or slippage, and researchers controlled for inappropriate use, such as absent or inappropriate lubricant, Penile piercings, or unrolling the condom before fitting it to the penis.
Overall, no significant differences were found between the two types of condom. Rates of failure were similar as reported during heterosexual use. Factors influencing condom failure were also similar to those previously identified in studies of heterosexual use of condoms; unrolling the condom before placing it on the penis, longer duration of intercourse and using inappropriate (oil based) lubricant.
The authors concluded that the use of standard condoms may prove to be more acceptable to gay men but stressed they need be reminded to:
- unroll the condom after fitting it to the penis
- use additional lubricant
- apply the lubricant to the outside of the condom
- apply the lubricant in and around the anus.
Harding R et al. A clinical trial of a thicker versus a standard condom for gay men. Thirteenth International AIDS Conference, abstract WePpC1395, Durban, 9-14 July 2000.