Gay men, female condoms & anal sex - myth or reality?

Female condoms were the first product developed to offer women more control over HIV prevention methods. The Reality^TM condom was approved in the USA in 1992 for vaginal contraceptive use. Latex male condoms have been associated with usage problems including, breakage, slippage, latex allergies and lack of control by receptive partners. Although female condoms are essentially not designed for the purpose, some gay men have used them and it seems they do provide an effective barrier during anal sex.

Research published in the March edition of the journal AIDS has assessed the safety and acceptability of a brand of female condom called Reality^TM for anal sex among gay men. The study enrolled 56 monogamous seroconcordant gay male couples who had not used condoms in the past three months were randomised to use latex male condoms or the Reality^TM female condom for anal sex. On study entry the men were given 10 Reality^TM or lubricated male condoms to use with lubricant during the following six weeks. In the second six weeks the couples crossed over and began using the other condom type.

The Reality^TM condom has two polyurethane rings and a thin, loose-fitting polyurethane sheath which in laboratory studies has been shown to be impermeable to viruses and less likely to rupture than latex condoms. Since it is made of polyurethane it can be used with both water-based and other kinds of lubricant. In this study couples were advised to remove the inner ring to reduce potential rectal trauma and bleeding.

Receptive partners were more likely to report pain or discomfort with the Reality^TM rather than the male condom. Both partners were significantly more likely to report Reality^TM condom slippage during use or withdrawal. Rates of condom breakage were similar for Reality and male condoms.

After using both sets of condoms , both active and passive partners were significantly less likely to be willing to use Reality^TM condoms in the future with partners of unknown HIV than they were to be willing to use male latex condoms; (21% of receptive and 26% of insertive partners would be willing to use Reality^TM condoms, compared to 61% of both receptive and insertive partners who were willing to use latex condoms. The main reason reported by those who would be willing to use the Reality^TM condom with future partners of unknown HIV status were that the Reality^TM condom was more comfortable, easier to use, and perceived to be stronger and safer.

The researchers suggested that gay men who are considering using

the Reality^TM condom might require training relating to slippage and methods for avoiding semen spillage that might expose the anal mucosa.

They added "further work is warranted on design modifications, safety and acceptability of the Reality^TM condom in HIV-negative gay men".

Further information on this website

Condoms - Factsheet