My partner and I enjoy anal sex but we just heard that the female condoms we were using might not be safe. Is this true, and if so, what precautions should we use in practicing safe sex?

The female condom (Reality) is a loose sheath of plastic that lines the vagina. It has a soft ring at each end. The ring at the closed end is used to put the device inside the vagina and holds it in place. The other ring stays outside the vagina and partly covers the outer area.

Product labelling is for vaginal use only. More research needs to be done about the use of the female condoms in anal intercourse. Compared to vaginal intercourse, male condoms break at a higher rate during anal sex.

In a recent (Nov. 1999) article published in the American Journal of Public Health, the authors interviewed 100 gay men who had sex using the Reality Female Condom.

In that study 40 percent of these men reported problems with the condom. Problems included: pain, difficulty inserting the device and difficulty keeping it in place. Four users reported rectal bleeding. This last symptom is of concern because there is obvious damage being done and the laceration and the blood itself can transmit the AIDS virus.

Eighty-six percent of respondents said they would use Reality again and 54 percent would rather use Reality than penile condoms. Acceptability was higher among those who were HIV positive, in nonmonogamous relationships, or who had non-infected partners. Negative experiences included: difficulty inserting (33 percent), irritation (17 percent), bunching up (12 percent), unpleasant texture (10 percent) and noise (9 percent). Breakage was reported three times in 334 episodes of use. There is no available data which compare preferences and efficacy of Reality to male condoms.

Due to the need to insert the soft ring at the closed end of the female condom, it does take some manipulation and practice to insert this device. Lubrication and gentleness are two key ingredients.

The researchers conclude that "use of the female condom for anal sex should be evaluated for safety and effectiveness before it is widely promoted." HIV is more readily passed during anal sex than during vaginal intercourse, so it is important to know your HIV status as well as that of any partner.

Anal relaxation exercises are recommended prior to any attempt at penetration, as is the use of condoms with water based lubrication as a protection against HIV.