Mantell Joanne E, Kelvin Elizabeth A, Exner Theresa M, Hoffman Susie, Needham Sarah, Stein Zena A
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, USA.
AIDS Care. 2009 Sep;21(9):1185-94. doi: 10.1080/09540120902730005.
Despite limited safety data and the absence of efficacy data, several studies have reported that the female condom is being used for anal sex by men who have sex with men. We describe providers' awareness of female condom use during anal sex among their clients and their experiences in counseling clients. We conducted semi-structured interviews with 78 health-care providers recruited from various health-care delivery systems in New York City: a family planning agency, a sexually transmitted infection agency, a hospital-based obstetrics and gynecology clinic, and two community-based AIDS service organizations. While two-thirds of providers reported that they were uncertain as to whether the female condom could or should be used for anal intercourse, nearly one-third believed that anything is better than nothing to prevent HIV/sexually transmitted infections during anal sex. Few providers had actually talked with clients about anal use of the female condom, and clients themselves had seldom mentioned nor asked for information about such use. Our findings highlight providers' uncertainty about anal use of the female condom. Lacking guidelines regarding the safety and efficacy of female condom use during anal sex, health-care providers are left to make their own well-intentioned recommendations (or not) to potential users. The dearth of information on female condom use during anal sex could encourage individuals to use the female condom for anal sex, which may increase HIV transmission risk or represent a missed opportunity for protecting non-condom users. There is a need for a series of harm-reduction, acceptability, and efficacy studies and, in the interim, for the development of a carefully qualified safety set of guidelines regarding anal use of the female condom for health-care providers.
尽管安全性数据有限且缺乏有效性数据，但多项研究报告称，男同性恋者正在将女用避孕套用于肛交。我们描述了医疗服务提供者对其客户在肛交时使用女用避孕套的认知情况以及他们在为客户提供咨询方面的经验。我们对从纽约市各种医疗服务提供系统招募的78名医疗服务提供者进行了半结构化访谈，这些系统包括一家计划生育机构、一家性传播感染机构、一家医院的妇产科诊所以及两家社区艾滋病服务组织。虽然三分之二的提供者表示他们不确定女用避孕套是否可以或应该用于肛交，但近三分之一的人认为在肛交时采取任何措施预防艾滋病毒/性传播感染总比什么都不做好。很少有提供者实际与客户谈论过女用避孕套用于肛交的情况，客户自己也很少提及或询问过此类使用信息。我们的研究结果凸显了提供者对女用避孕套用于肛交的不确定性。由于缺乏关于女用避孕套在肛交时安全性和有效性的指导方针，医疗服务提供者只能自行（或不）向潜在使用者提出善意的建议。关于女用避孕套在肛交时使用的信息匮乏可能会鼓励个人将女用避孕套用于肛交，这可能会增加艾滋病毒传播风险，或者意味着错失保护未使用避孕套者的机会。需要开展一系列减少伤害、可接受性和有效性研究，在此期间，还需要为医疗服务提供者制定一套关于女用避孕套用于肛交的经过仔细限定的安全指导方针。
