Jul 14, 2006
I just want to offer up something that some of my clients have found very useful. It is true that all condoms will fit all sized penises and it is also true that men who are very thick often times find condoms tight. This sometimes leads to a person not being able to maintain an erection. Anyways a creative solution that two of my clients and their partners were very satisfied with is using a "Female" condom or as I call them an insertive or internal condom. Internal condoms can be a bit tricky the first time so some "practice" is useful. For a women the directions on the package are pretty explanatory. For a man it is a little trickier and one has to find what they like, many men like to remove the inner ring before inserting it, some don't. One thing for sure is put some lube on the outside and the inside of the condom. The easiest way for a man to insert the condom is to have the insertive partner (top) use his penis to put it in. One can also use a dildo to insert the condom. Internal condoms are polyurethane and are therefore much less likely to break then latex condoms so this is very useful to folks like the man with the 11 inch 8 around penis who said that he often broke condoms. Polyurethane also transfers heat and some men like that a lot, in fact my clients report that the sex with internal condoms is very close to the sensation of not wearing a condom. I know that internal condoms are not approved for use by men and that some men experience discomfort due to the seam, but it is another method of staying safe while having fun, and to quote the one and only Dr. Bob, HIV cannot pass intact polyurethane no way, no how!
DC Health Educator
Response from Dr. Frascino
Hi DC Health Educator,
I agree they are worth a try, keeping in mind the caveats you mentioned. I have addressed the topic of female condoms several times in this forum and will print several of those posts from the archives below for additional information.
Thanks for your input!
My new boyfriend is Positve Feb 16, 2006
The guy I am dating for the past two months is HIV pos. He is a great guy and dropped a hint the let me know on the first date. He has been very open about his life before and after HIV. We both come from backgrounds of loosing lovers in the past. We have not discussed circumstances around his loss but he is aware of mine (NON HIV loss). We have dated for 2 months and yet to have sex (yeah I know we are gay men that are almost trying to hetro). I am sooo very ready to have sex but know that he may not be ready. He says he does not have a problem with me being negative. I don't have a problem with his being positive, though I am sure I will have many questions for awhile. My question is two fold. One how safe is using a female condom for gay men during anal sex. Two.... am I out of my mind telling him that I will not use condoms for oral sex?
I used to teach AIDS education for a non profit. I know the risks but I have a couple of friends screaming that I am crazy for not wanting to use condoms for oral sex. As far as the female condom goes I have heard that it creates a bit more non condom feeling but have not tried one and want to know if there is risk in using one.
Response from Dr. Frascino
The female condom is made of two flexible polyurethane rings and a loose-fitting sheath. It is approved for contraception and HIV prevention during heterosexual vaginal sex. Its safety and efficacy for anal sex has not been proven. Consequently it cannot be formally recommended for this use. That said, certainly MSM (men who have sex with men) have nonetheless begun to use them for anal sex. Anecdotally it has been reported that they increase sensitivity for the insertive partner compared to latex male condoms. This is presumably due to the large size and polyurethane composition. I do know of one study that's a couple of years old now that found about 50% of men using female condoms for anal sex reporting problems, including rectal bleeding. Anecdotal evidence suggests that removing the inner ring, lubricating the inside, placing the condom over the throbbing woody, lubricating the outside and then entering the receptive partner eliminates some of the discomfort and trauma. Also one must take care that the outer ring of the condom doesn't enter the rectum during the backdoor action.
Regarding your second question, unprotected oral sex carries a low risk for HIV transmission. Each of us must determine what level of risk we are comfortable taking. One thing to keep in mind is that when you are part of a magnetic couple, you both need to agree on what level of risk you are willing to accept, based both on individual comfort level and medical facts. So even if you know the facts and are comfortable having unprotected oral sex, your partner may not agree. Communication is the key to a successful and healthy sex life. I suggest you read through the information on magnetic couples (serodiscordant couples) in the archives of this forum. Share the information with your new boyfriend. Write back if you have additional concerns. I do have personal experience in this arena, as I have been part of a magnetic couple for over 12 years. I am HIV positive and my partner Steve (Dr. Steve, the expert in The Body's Tratamientos Forum) is HIV negative. We continue to have a romance that others only dream about. And yes, it includes toe-curling, wake-the-neighbors passion. Certainly in our case, opposites do indeed attract.
female condoms Aug 26, 2005
Hi Dr Bob,
I was just reading a question from July 23rd from an HIV+ lady who couldn't use condoms with her boyfriend because he couldn't keep it up. I had a similar problem with a boyfriend and found that the female condom (marketed as Femidom over here in the UK) offers much more sensation for the guy, enabling him to keep it up! They're a bit more expensive than ordinary condoms, but I found they were definitely worth it. If, in your opinion, they are as effective as latex condoms for preventing HIV transmission, I would highly recommend them to anyone in similar circumstances :)
Love your forum by the way. You are sooooo handsome *swoon*!
Response from Dr. Frascino
Thanks for the tip! I'll post this response in the Safe Sex/HIV Prevention Forum as well.
For those readers unfamiliar with female condoms, they are made of two flexible polyurethane rings and a loose-fitting polyurethane sheath. They are approved for contraception and HIV prevention in heterosexual sex. In studies of acceptability, between 50% and 73% of women liked them as much or better than male condoms. Acceptance was somewhat less among their male partners, with only 44% reporting they liked the female condom as much or better than male condoms. However, they are certainly worth a try, and there is no doubt they represent an important advance in HIV prevention as a female-controlled HIV-prevention method.
Regarding the swoon . . . I'll be right over to perform mouth-to-mouth resuscitation.
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