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Female condom and HIV
Oct 21, 1996

I am a sexually active woman. I have started to use the new female condom, and feel confident with it, I have even managed to insert it in my rectum for anal sex. Do you think I can stop asking the men I date to use condoms? I feel pretty safe with the female condom. Am I right? Thanks

Response from Mr. Sowadsky

Hi. Thank you for your question.

The female condom is an alternative for women when a man doesn't want to use a male latex condom, or for persons who are allergic to latex. The female condom is made out of polyurethane, a type of plastic. There is now a polyurethane male condom available on store shelves as well, for persons allergic to latex. It's important to understand that in typical use, the female condom offers less protection than the male latex condom. This is primarily because the female condom is more difficult to use. The annual failure rate for pregnancy for typical use is approximately 21%. The female condom comes with lengthy instructions, which are important to read prior to use. If not used correctly, the female condom will not protect you as well. Both the female and male polyurethane condoms can be used with any type of lubricant. This differs from latex condoms which must be used with a water-based lubricant only. Both the female and male versions of the polyurethane condoms cost more than the typical male latex condom.

At this time, the female condom is approved for use only for vaginal intercourse. There are no completed studies that have been done regarding the use of this condom for anal intercourse. I must say however that for the majority of the population, the female condom is too large to insert anally for proper use and comfort. Until the FDA provides studies as to the use of this product for anal sex, I can only recommend the female condom for vaginal sex only.

The female condom cannot be used in conjunction with the male condom. It's either one or the other. For maximal protection, I still recommend the male latex condom, which provides a higher level of protection than the female condom. I would not stop asking men to use the male latex condom if you want to have the highest protection possible against HIV and other Sexually Transmitted Diseases (STD's). But if a man refuses to use a condom with you, the female condom is certainly an option, and provides more protection, than using nothing at all.

Interestingly enough, although the female condom was intended to empower women to protect themselves, many women I have spoken with stated that they prefered male condoms. This was because it gave the man some responsibility in regard to infection and birth control. Some women didn't want to "bother" with yet another form of birth control. Different women think differently on this issue.

My suggestion to you is to still insist that your male partners use the male latex condom (for you to receive the maximal protection). If they won't use it, or if they are allergic to latex, then certainly consider using the female condom as a back-up, especially if you are comfortable using them, and know how to use them correctly. I cannot however recommend using the female condom for anal sex until further studies look at the use of these condoms for this type of sex.

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide). Rick Sowadsky MSPH CDS



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