Adding the Female Condom to the Public Health Agenda on Prevention of HIV

Adding the Female Condom to the Public Health Agenda on Prevention of HIV and Other Sexually Transmitted Infections Among Men and Women During Anal Intercourse.

Legal barriers to conducting public health research on methods of protection for anal intercourse were lifted in the United States in 2003 when the US Supreme Court invalidated all state antisodomy laws. Although research funding has been available for the development of rectal microbicides, the female condom, which has already been approved for vaginal use, has not been evaluated for anal use. Although there is no evidence that the female condom is safe for anal intercourse, it has already been taken up for off-label use by some men who have sex with men. This demonstrates the urgent need for more protection options for anal intercourse and, more immediately, the need to evaluate the safety and efficacy of the female condom for anal intercourse.

Among men aged 25 to 44 years in the USA, 3.9% report having had anal sex with another man and 40% report having had anal sex with a woman. It is estimated that four times as many women in the USA practice anal sex than do men who have sex with men. Although the ‘female condom’ is recommended by some health providers and health promoters for anal sex, it has not been assessed for safety, ease of insertion (for example, should the inner ring be removed?), or efficacy. With the development and testing of rectal microbicides lagging behind vaginal products, quick studies to determine the optimal method for using the female condom during anal intercourse are needed now.