Rural Center for AIDS/STD Prevention

RAP Time

(Volume 3, No. 6, June 4, 1999)

Issue Contents

Men Willing to Have Sex with Female Partner Wanting to Use The Female Condom

The female condom is an important new advancement for combating HIV and other STDs. Clinical trails suggest that the device is a highly effective in preventing transmission of HIV/STDs if properly used.

The female condom allows women to assert more control over their sexual relations, thus reducing their risk of HIV/STD. Many women still report a need to obtain their partner's consent prior to using this device. Widespread acceptance of the female condom is an important public health goal.

This study determined heterosexual men's familiarity with the female condom and their attitudes toward it.

Sample and Methodology
Interviews were conducted with 71 ethnically diverse and heterosexually active men recruited in STD clinics and through word of mouth in areas with high HIV/STD seroprevalence in New York City during fall 1994 to fall 1995.

Outcomes of the Study
Men ranged in age from 18 to 38 years with a median age of 25. Fifty-one percent were black/African American, 25% Latino, 17% white, and 7% mixed-ethnicity. The median education level was graduation from either high school or a vocational program. About two thirds were involved in a steady relationship.

Major findings include:

  • Only one man had direct experience with the female condom. He reported largely negative reactions by him and his female partner. He stated that he would not recommend the female condom to others.
  • Of the remaining 70 participants, 29 men reported no previous knowledge of the female condom. Thirty-four men reported that although they had previously heard or actually viewed the female condom, they had little knowledge about it. Only seven men possessed considerable familiarity with this device.
  • The participants' attitudes ranged widely with 26 men expressing generally positive, 17 men ambivalent, and 28 men generally negative attitudes toward this device.
  • Many men had questions about the disease and pregnancy prevention efficacy of the device, as well as the effect of it on a person's sexual pleasure.
  • Common misconceptions included beliefs that the female condom is just for pregnancy prevention, that it does not offer disease protection for men, that it should be used with the male condom, and that it is too small for a man's penis.
  • Although few men expressed a desire to try sex with a woman who was using the female condom, most men reported that they would be willing to try the female condom if requested by a female partner.

Implications for Prevention
The study results reinforce the importance of including heterosexual men in HIV/STD prevention programs. Clearly, educational efforts are needed to increase heterosexual men's awareness of the female condom.

SOURCE: Seal, D. W., & Ehrhardt, A. A. (1999). Heterosexual men's attitudes toward the female condom. AIDS Education and Prevention, 11, 93-106.

Networks of Youth at Risk for HIV/STD Exist in Rural Communities

CDC recently assisted the New York State Department of Health and the Chautauqua County Department of Health in an investigation of a cluster of HIV infections among young women, reportedly infected through heterosexual sex with the same man.

The study revealed that 13 of the 42 identified primary sexual contacts of the infected man were HIV-positive. DNA analysis revealed that at least 10 of these young women (ages 13-24) were infected by the same source. Findings suggest that HIV was transmitted heterosexually from one infected male to a large percentage of his female partners.

Unrecognized social and sexual networks of youth at high risk for HIV/STD exist even in rural areas, and these networks can facilitate the rapid spread of HIV infection. Public health programs should provide effective HIV prevention services to youth in rural communities.

SOURCE: CDC (1999). Cluster of HIV-positive young women, upstate New York, 1997-1998. MMWR, 48, 413-416.

Acceptance of Female Condom for Anal Sex High among MSM

A self-administered, anonymous questionnaire soliciting opinions and experiences using Reality, the "female" condom, for anal sex was completed by a convenience sample of 100 men who have sex with men (MSM).

Eighty-six percent said they would use Reality again, with 54% indicating they would rather use Reality than penile condoms. Acceptability was higher among MSM who were HIV positive, in nonmonogamous relationships, or who had serodiscordant partners.

Negative experiences while using Reality included: difficulty inserting (33%), irritation (17%), bunching up (12%), unpleasant texture (10%), and noise (9%). Breakage was reported three times in 334 episodes of use.

Reality is a welcome alternative for some MSM who have difficulty consistently using penile condoms and it probably reduces HIV transmission compared with unprotected sex. Research is needed to assess Reality as a risk reduction method for MSM.

SOURCE: Gibson, S., et al. (1999). Experiences of 100 men who have sex with men using the Reality condom for anal sex. AIDS Education and Prevention, 1, 65-71.

HIV Positive Persons with Multiple Partners Less Likely to Disclose

HIV-positive individuals who used condoms inconsistently and who had multiple sexual partners were less likely to have disclosed their HIV status to their partners. Also, continued lack of disclosure to partners was common.

SOURCE: Niccolai, L. M., et al. (1999). Disclosure of HIV status to sexual partners: Predictors and temporal patterns. Sexually Transmitted Diseases, 26, 281-285.

Most Have No Sex While Symptomatic

Sixty percent of STD clinic patients surveyed had not had sex while symptomatic. For men having sex while symptomatic, 30.7% had two or more partners; among women only 16.5% had more than one partner. Among those reporting sex, 17.2% stated that they always used condoms while symptomatic.

SOURCE: Irwin, D. E., et al. (1999). Self-reported sexual activity and condom use among symptomatic clients attending STD clinics. Sexually Transmitted Diseases, 26, 286-290.