The modern condom as we know it has been around for more than 160 years as a source of protection against pregnancy and sexually transmitted diseases. But people are looking at other options, especially for anal sex.
Most condoms on the market are designed for vaginal sex. Texturally and muscularly, the rectum and vagina are quite different. Experts say the added friction of anal intercourse can exacerbate problems associated with an ill-fitting condom. Too tight or too loose, the condom can break or slip off, defeating its purpose.
“Some recent data suggest that for some men the standard condom may be inadequate, resulting in breakage, slippage or improper use and subsequently may lead to infection,” says a backgrounder for the Ontario Men’s Survey, a province-wide study of men’s sexual health and behaviour, now being conducted out of the University Of Toronto.
San Francisco AIDS activist Michael Petrelis says that although a polyurethane pouch was approved as an AIDS barrier by the US Food And Drug Administration (FDA) in 1992, it was approved only as a vaginal device. Due to sodomy laws that still exist in many US states, Petrelis says the FDA denied approval of Reality – the “female condom” which is inserted into the vagina before intercourse – for anal use. These US laws end up affecting condoms that are available in Canada.
James Murray of the gay men’s community development program of the AIDS Committee Of Toronto agrees that condom use isn’t always perfect.
“A lot of men have had issues about condoms that are too loose or too tight, resulting in anxiety,” says Murray. “As well, they are now finding that condoms with the spermicide Nonoxynol Nine can actually irritate the lining of the anus or vagina making it more susceptible to the transmission of HIV.”
Trevor Gray, co-ordinator of the Men Together Project of the Black Coalition For AIDS Prevention, says that many of the people he talks to have issues with the condoms that are on the market.
“We hear complaints that condoms are too small or too tight,” says Gray. “At first, we thought that people didn’t want to use them. Then we heard more about condoms cutting off circulation, making the penis go flaccid.”
Are there condoms designed for anal sex? Durex of Canada said it shouldn’t be a problem.
“We do not distinguish between homosexuals and heterosexuals and we promote sexual health and well-being. We encourage people to have safe sex,” says a spokesperson for Durex.
When the Reality female condom was launched in 1996, activists like Petrelis suggested that it might be a better option for anal sex, or that its design could be adapted for anal sex. Because it can be inserted before a sexual encounter starts, the theory was that one wouldn’t have to worry about a partner’s compliance or anxiety over condom use.
That excitement has since petered out. There have been reports of problems with the female condom getting pushed aside by the penis, resulting in unprotected sex.
Gray says he’s heard of some men using Reality, but has been told that “they make a lot of noise.”
Louise Binder, chair of Voices Of Positive Women, says the development of an effective gel or cream barrier might be the biggest advance over the condom – for men and women. But she says there’s not enough work being dedicated to developing the product.
“Drug companies don’t want to put research money into it,” says Binder. “They don’t think there will be a big enough market and they say they’re worried about liability.”
Binder admits that even this form of protection is more appealing to woman than to men. The effects in anal sex remain understudied.
“At AIDS Awareness Week two years ago, we tried to make microbicides the theme. The consensus of many of the men was that it applied to women, not men. They said there would have to be proper clinical trials to know if it worked properly for men having sex with other men.”
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