[Brand names used here are for identification purposes only and do not imply endorsement of any kind.]

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Contents


Can Safer Sex Be Latex Safe?

Based on a 1997 article by Lillie C. Thomas, M.S.

"I need a rubber."
"I’m looking for my glove."
"Don’t touch the rain without a rubber raincoat."

All of these are slang statements for one thing, the latex condom, the most effective barrier protection and the hallmark form of protection recommended by the FDA and the CDC and the most common birth control device used to engage in safer sex. The U.S. uses approximately 1 billion latex condoms per year. Despite this, 13 million people in the U.S. will contract an STD this year, 1/3 of whom will be teenagers less than 15.

Safer Sex Is Essential

Between the ages of 15 and 55 one in four Americans will become infected with an STD.1 A monogamous sexual relationship between uninfected partners is the best way to avoid contracting a STD. The most devastating STD is AIDS, the second leading cause of death among women, and if recent estimates are correct, a disease which will increase to affect 130 million people worldwide by 2002. By 2000 women will out number men as the leading sufferers of AIDS, as it has now entered the mainstream of the heterosexual population. 2 The U.S. also has one of the highest pregnancy rates, with the average age of the unwed mother now being 15.3

Not Into Abstinence?

If abstinence or monogamy is not your choice, the consensus of the Center of the Disease Control and the medical literature is that the latex condom is the most effective protection and that "condoms should be used by those who desire protection from pregnancy and/or sexually transmitted diseases (STD’s), since [condoms] are the only product available that fulfill both roles."4 The medical literature also states "condoms are the most effective non-prescription contraceptive method for men. They are readily available, simple to use, relatively inexpensive, and are not associated with any side effects." 5

Barrier Method

Condoms are a barrier method of protection. The barrier method has been shown to be effective in preventing both pregnancy and STD’s.6 The increased use of condoms since 1985 has primarily been the result of the usage of the condom to prevent the transmission of STD’s. The transmission of STD’s including HIV (AIDS) takes place with the exchange of body fluids. Condoms, as barrier method can, when properly used, prevent contact between body fluids. When used properly, consistently and prior to any sexual contact, condoms provide a barrier against this exchange of body fluids, the primary carrier for many STD’s including HIV (AIDS).7 The FDA policy guidelines also indicate general acceptance that condoms are an effective barrier against STD’s.8 The medical literature has concluded that STD’s are "virtually 100% preventable with proper condom use."9

It is generally accepted that condoms are the only effective barrier method for both pregnancy and STD prevention, but when a natural rubber latex allergy (Type I) or contact dermatitis (Type IV) is your diagnosis, latex condom use, although it is the preferred method of protection, becomes impossible. Additionally, contraceptive methods like the diaphragm and the cervical cap are also eliminated because they are also made of natural rubber. Life, and especially sex, doesn’t end because of a positive diagnosis for latex allergy. There are alternative birth control methods and STD protective methods which can afford much the same protection as a latex condom and can be used when latex is not for you.

Safer sex for those with Type IV allergy:

This is a contact allergy, usually to the preservatives and accelerators used in making latex, not the rubber proteins themselves. For some users, the contact effects can eliminated by a change in the brand of condom used. Each condom manufacturer uses a different formula and the accelerators and antioxidants which generally cause the Type IV reaction change from brand to brand. For others, using a natural membrane condom under the latex condom (if the contact allergy affects the male), or over the latex condom (if it affects the female) provides adequate protection from the contact allergy while providing all of the benefits of a latex as a protection from STD’s. The most popular brand of natural skin condoms is Trojan Naturalamb®. These generally are available in condom specialty stores, (Los Angeles and New York), large grocery or drug store chains, (Savon, Safeway or Revco) or the Internet (http://www.condomania.com or http://www.condom.com).

No STD Protection

Use of a natural skin condom alone, while it can be effective in preventing pregnancy, is not recommended for protection against STD’s. The combination of a natural skin and latex condom is also not recommended if either partner is Type I latex allergic, particularly if used with Nonoxynol-9 spermicide. The spermicide can leach out latex proteins at a rate four times higher than found in a lubricated condom, and the natural material condoms are permeable and could allow the allergens to pass through.

For Those with Type I Latex Allergy:

Female Condom

There are several new alternatives for use that provide controlled protection from STD’s and birth control without latex. The best barrier method which woman can use and exclusively control is the female condom. The female condom is a polyurethane pouch which can be inserted and used with or without added vaginal spermicide. As it is made of polyurethane, oil based lubricants and scented oils can be used without interfering with the effectiveness of the device. In the U.S. the brand name is "Reality®," abroad it is called Femidon. It is manufactured by the Female Health Corporation. A patented device, there is no competition in brands. It is an "over the counter" device and there is no age requirement for purchase. Insertion of the female condom is essentially the same as that of a diaphragm or the cervical cap (the female condom uses a top flexible ring to hold it in place) and the open end hangs free outside the vagina.

Lubrication is important particularly at the beginning of intercourse, to assure that the female condom does not "bunch up" allowing body fluid contact and losing its effectiveness. A new female condom should be used for each sex act. Because this is a new product, long term effectiveness studies are not yet available. Studies do indicate that 84% of the women who used the female condom like it, and 66% prefer it to the male condom but men may not be as receptive. Women find the female condom easier and more comfortable to use.10 Effective use of the female condom does require practice and the more it is used, the less breakage or slippage occurs.

With experience the female condom has a contraceptive failure rate of about 5%.11 For the female who is also latex allergic and desires to engage in intercourse in situations where a barrier method is absolutely required, the female condom offers the best alternative, as it provides her the ability to control the material touching her body and control her exposure to STD’s. The female condom is not to be used with a male condom.

Polyurethane "Plastic" Male Condom

The best barrier method that is male controlled for latex sensitive is the polyurethane male condom marketed under the brand name Avanti®. This condom works in every respect like a latex condom, except that it may not have the same elasticity. This polyurethane condom is manufactured by London International Group. Other manufacturers (Carter Wallace the manufacturer of Trojan®) have also received clearance to market the device, however no other brand has entered the U.S. market at this time (January 1998).

In test market states polyurethane male condoms can be found drug stores, department stores and grocery stores. It is also available to those not in test market states via the Internet from http://www.condomania.com or http://www.condom.com. The advantage of this condom is that it is a non-latex material that has good heat transfer properties and better storage stability than latex. The FDA has cleared this device for test marketing in some states while the effectiveness studies are completed. The CDC recommends this device be used when a latex condom cannot. In preliminary studies conducted, it appears there is little difference between latex condoms and polyurethane condoms for breakage or slippage.12, 13 As with latex condoms, the more frequently and consistently the polyurethane condom is used, the less likely there will be a consumer error resulting in a failure of the device. This product can be lubricated with a spermicide by the manufacturer and should be used with a vaginal spermicide.

The only viable method for both STD and pregnancy prevention is the use of an intact condom, whether it is female or male made of a suitable material which has been tested for barrier properties. When using these alternate material condoms, lubrication is absolutely required to improve fit and comfort.

Pregnancy Prevention Only

There are also some barrier and protective devices which can be used by the latex allergic when prevention of pregnancy is the only goal (that is, when the partner is known to be otherwise "safer").

Contraceptive Sponge

The contraceptive sponge is a barrier method which offers protection against pregnancy, but no protection against STD’s. Made of polyurethane foam, it is latex free and as effective as the cervical cap or the diaphragm.14 It was marketed in the U.S. as "Today(tm)" until the manufacturing facility could not comply with the applicable FDA requirements and ceased manufacturing. Currently the sponge is available in Canada as Protectaid® and can be purchased through the Internet from http://www.birthcontrol.com/sponge.htm in Canada. Shipments to the U.S. may have been intercepted by U.S. Customs. The sponge is inserted like a diaphragm or cervical cap.

Vagina Creams and Suppositories

Vaginal creams and suppositories with the principle ingredient nonoxynol-9 can also be used as spermicides to prevent pregnancy. The principle ingredient in the vaginal creams is Cellulose gum (number one ingredient in most preparations) and the largest selling retail brands in the U.S. are Gynol II(tm), or Conceptrol®. For some, this may make suppositories a better choice. The vaginal suppositories do not contain gums, but do contain sodium bicarbonate or sodium trideceth sulfate. This method may offer some limited protection against STD’s.

Silicon Diaphragm

Available only through physicians. Manufactured by Milex Industries of Chicago, Illinois. Only one size available, sold only to physicians. A physician can order this product for a patient if the size works for that patient (size/fit is quite important in the effectiveness of a diaphragm in preventing pregnancy). (The FDA issued a warning letter to Milex in April 1997 on a birth-control-related "good manufacturing practices" issue - the FDA search engine doesn't give a brief URL, or I would include it here. The warning letter is available in *.pdf format.)

Nonoxynol-9

The medical literature indicates nonoxynol-9 may provide some protection against gonococcal and chlamydial cervical infection. 15,16 Nonoxynol-9 has also been shown in vitro to inhibit growth of Treponema pallidum, N gonorrhoeae, C trachomatis, herpes simplex virus, and HIV. 17,18,19 Additionally, Nonoxynol-9 can reduce the incidence of HIV infection in laboratory tests,20 and Nonoxynol-9 has also been shown to effectively inactivate high titers of HIV in vitro. 21 However, the effectiveness of Nonoxynol-9 against STD’s, particularly AIDS, has not been proven in humans.22

N-9 Vaginal Contraceptive Film

On the horizon is a new vaginal barrier product often referred to in the medical literature as N-9 film. It has been released for sale by the FDA to the U.S. market which will be available under the marketing name VCF Vaginal Contraceptive Film. This product has been shown in studies to be effective against pregnancy, but it offers little additional protection against STD’s. As this product is not currently available for retail sale, there is no information regarding its safety for the latex allergic.

Oral Contraceptives

For those who are latex allergic and currently using oral contraceptives, the concurrent use of steroids as part of the treatment of the symptoms of latex allergy should be carefully reviewed with the prescribing physician. Any treatment which adds to cardiovascular risk adds to the risk of the oral contraceptive. This is particularly true if the user of the oral contraceptive is over 35 years of age.23

Rashes and Burning Should be Taken Seriously

If you have not yet been diagnosed as latex allergic and are not sure if you are, rashes, burning or any observed changes in the genitals during or after latex use should be taken seriously. Although from 1988 through 1992 the FDA only received 44 complaints of irritation during condom use when over 6 billion condoms were used, the user needs to be aware of their own bodies and their partner’s. People who are health care workers, rubber industry workers, patients with multiple medical procedures, or those with allergies especially to bananas and avocados should be especially careful.

In Conclusion

It is possible to practice safer sex and be latex allergic. It is particularly important for the latex allergic person to control the contraceptive devices used to prevent accidental latex exposure from a less informed partner. By control of the methods used, the latex allergic person subordinates the allergy, which is sometimes a centerpiece of their lives, to its place as a controlled medical condition.


Table I

[* Brand names used here are for identification purposes only and do not imply endorsement.]

Product*

Availability

Price Range

Trojan Natrualamb®

Condom specialty stores

Adult stores

Internet mail order

$9.95-$11.95/3 pack

$39.95-44.95/12 pack

Reality® Female Condom

Discount department stores

Drug stores

Grocery stores

Internet mail order

$6.95 to $8.99/3 pack

Avanti® Condom

In test markets at drug stores and grocery stores

Internet mail order

$7.95 to $8.95/6 pack

 

Protectaid® Sponge

Canadian retail outlets

Internet mail order

$8.40(Can)/4 pack

Vaginal Creams

Gynol II(tm), Conceptrol®

Grocery stores

Drug stores

Discount department stores

$8.95-11.99 depending on brand and quantity

Vaginal Suppositories

Conceptrol® Semicid®

Grocery stores

Drug stores

Discount department stores

$7.49-$8.99 depending on the brand, usually package 10/pack

Footnotes

Back to the top

In order of appearance.
  1. American Foundation for the Prevention of Venereal Disease Statistics, 1994.
  2. M.A.J. McKenna "In the Age of AIDS," The Atlanta Journal and Constitution, 1997, July 29; F01.
  3. U.S. Bureau of the Census, 1990.
  4. Anderson, Frank W.J., "Condoms: A Technical Guide," The Female Patient, Vol. 18, April, 1993.
  5. Billow, J.A., Choosing Condoms," American Pharmacy, Sep. 1992, NS32(9):55-8.
  6. Center for Disease Control, "Update: Barrier Protection Against HIV Infection and Other Sexually Transmitted Diseases," Morbidity and Mortality Weekly Report, August 6, 1993, 42(30).
  7. D'Oro L.C., et al. "Barrier Methods of Contraception," Gentouri Med., December, 1994, 70(6):410-17.
    This article is a review article which shows epidemiological studies show a reduction of risk, presenting results of over 60 papers.
  8. FDA Letter to condom manufacturers dated April 7, 1987.
  9. Consumer Union of the U.S., Consumer Reports, May, 1995
    quoting American Journal of Public Health (and reprinted from http://www/youth.org/news/0495/condoms.html).
  10. Ruminjo, J.K. et al., "Preliminary comparison of the polyurethane female condom with the latex male condom in Kenya," East Africa Medical Journal, 1996 Feb., 73 (2):101-106.
  11. Sly, DE et al., "Factors associated with use of the female condom," Fam Plann Perspect, 1997 Jul, 29(4):181-184.
  12. Rosenberg, MJ et al., "The male polyurethane condom: a review of current knowledge," Contraception, 1996 Mar.; 53(3):141-146.
  13. Farr G., et al., "Safety functionality and acceptability of a prototype polyurethane condom," Advance Contraceptives, 1997 Dec.; 13(4):439-451.
  14. Trussell, J. et al., "Contraceptive efficacy of the diaphragm, the sponge and the cervical cap," Fam Plann Perspect 1993, May; 25(3):100-105.
  15. Niruthisard, S., et al., "Use of Nonoxynol-9 and the reduction in rate of gonococcal and chlamydial cervical infections," Lancet, July 18, 1992, 340(8812): 179.
  16. Stratton P. and Alexander N.J., "Prevention of sexually transmitted infections," Infectious Diseases of Clinical North America, Dec. 7, 1993, 7(4):841-59.
  17. Singh B., et al., "Studies on development of vaginal preparation...," British Journal of Venereal Disease, 1972, 48:57-64.
  18. Hierlro, D.R., "Inactivation of HTLV-III/LAV infected cultures by Nonoxynol-9," Lancet, 1985, 2:1422-1423.
  19. Singh, B., et al., "Virucidal effects of certain contraceptives on type 2 herpes virus," American Journal of Obstetrics and Gynocology, 1978, 125:422-425.
  20. Zekeng, L., et al., "Barrier contraception use and HIV infection among high risk women in Cameroon," AIDS May, 1993 7(5):725-31.
  21. Hochmeister, M.N., et al., "Effects of Nonoxynol-9 and the ability to obtain DNA profiles," Journal of Forensic Science, March, 1993 38(2):442-7.
  22. Family Health International, "FHI Examines N-9 Effect on STDS," African News Service, April 3, 1997.
  23. "Ischemic stroke and combined oral contraceptives," Lancet, American Foundation for the Prevention of Venereal Disease Statistics, 1994.

For More Information:

Here are links to information about and online stores for non-latex safer sex alteratives, romance, and also ordinary "safer sex" links that are NOT LATEX SAFE. The latex allergic person must practice all of the usual SAFER SEX methods of the non-allergic, while also remaining Latex-Safe.

Online Information About Non-Latex Alternatives:

Non-latex Condoms
http://www.thebody.com/sowadsky/answers/quest615.html

Go Ask Alice: Prefers POLYURETHANE Protection
http://www.columbia.edu/cu/healthwise/1203.html

Avanti Male Condoms
For more information about Avanti polyurethane condoms, contact London International, at (770) 582-2222.

Female condom and HIV
http://www.thebody.com/sowadsky/answers/quest118.html
Recommends against use in anal sex.

Female Condom Plays Vital Role In Safer Sex
http://www.twoten.press.net/stories/96/07/31/headlines/HEALTH_Female_Condoms.html

The Female Condom
http://www.io.com/~wwwomen/contraception/fcondom.html

Female Condoms
http://www.nau.edu/~fronske/fcondom.html

Ann Rose's Ultimate Birth Control Links
http://gynpages.com/ultimate/condom-female.html


Alternatives to Latex Condoms


For Sale Online Here:

Avanti® Male Condoms and Reality® Female Condoms
http://www.condomania.com/cgi-bin/SoftCart.exe/catalog/condoms/nonlatex/connltx.html?L+condomania+rudw1650+885831788

Avanti® Male Condoms
http://www.csense.com/condomz/products/condoms/avanti.html

Avanti® Male Condoms
http://www.blowfish.com/catalog/supplies/condoms_dams.html

Reality® Female Condoms
http://www.condom.com/Condom/Country/+CR-101-L|4302537359830804097605805846

Reality® Female Condoms
http://www.csense.com/condomz/products/condoms/reality.html

For Pregnancy Prevention Only:

Conceptrol®
http://www.marciaschs.com/p0000013.htm
Marcia's Confidential Healthcare Store, Inc.

Conceptrol®
http://www.male.com/pharmacy.htm#Spermicides


And don't forget there's lots you can do that's both safer and hot: kissing, stroking, mutual masturbation, massaging, grinding, hugging, nipple play, pornography, sex talk, necking games, romantic fantasy...use your imagination!

Romance Internet Resources

For some people, romance is a powerful turn-on and satisfier. Here are some links which should give you more than enough romantic notions. For those of you who are romance-aphobic, I say, "Get Over It!!!"


Safer Sex But
NOT LATEX SAFE

The following resources are NOT Latex Safe. They are included here only for those readers who are not yet aware of the details of safer sex information in the world outside of "Latex [Allergy] Land."

For safer sex links that are not necessarily LATEX SAFE, click here. Please note: Some safer-sex sites are not up to date with breaking news, particularly about non-latex alternatives, so please confirm everything you read with information sources you know and trust.

The 1995 Consumer Reports article excerpted below is generally NOT LATEX SAFE, but does contain some latex safe information -- that is what is shown below.



Consumer Reports: How Reliable Are Condoms?

The following is a portion of a copyrighted Consumer Reports article from May 1995. Below the excerpt there are links to the entire article. The article is very popular, and online in several locations.

\...\

TWO NONLATEX OPTIONS

If latex condoms irritate your skin, the culprit may be the lubricant, the spermicide or the materials used in processing. Try switching brands. If that doesn't work, you may be among the small percentage of people whose skin is sensitive to latex itself. You have two other choices in condoms, each with pluses and minuses.

"Skin" condoms are made from a natural pouch in lambs' intestines, and cost several times as much as latex ones. The membrane is especially strong and may enhance sensitivity. The downside: They have small holes. The microscopic pores in "skin" condoms can be up to 1.5 microns across. Since sperm cells are twice as wide as that, skin condoms still make an effective contraceptive. But viruses and some bacteria are far smaller than these pores. Lab work has shown that HIV and the herpes and hepatitis-B viruses can pass through skin condoms. So these condoms must bear a warning that they're not intended for disease prevention.

\...\

Last year, on the basis of limited testing, the FDA gave Schmid Laboratories approval to sell its new Avanti brand, a clear condom made of polyurethane. The agency justified approving the product because it felt a pressing public-health need to offer latex-sensitive people an alternative that could prevent disease as well as pregnancy. The Avanti condoms first appeared in Western states and should be available elsewhere by summer. But it's unclear just how much protection they offer.

A label on the Avanti's foil packet declares it "effective" against pregnancy and sexually transmitted diseases, while the label on the box warns that "the risks of pregnancy and STDs.. are not known for this condom." The FDA says it has noted the discrepancy. The packet label will be changed to match the box. The manufacturer says it has demonstrated to the FDA that Avanti does block viruses and neither slips nor breaks more often than latex. Studies of its contraceptive value are under way.

CR bought Avanti and Avanti Super Thin, which cost us $1.75 each, more than the most expensive latex condoms. Both products are in fact the same condom. The Super Thins come with more lubricant. In the lab, we found the condoms thinner than any conventional condoms tested, roughly 0.04 millimeters (mm). They're also among the shortest of condoms but wider than even larger-size latex brands (60 mm versus 55 mm or 56 mm). That's probably because polyurethane doesn't stretch as much as latex.

Despite the company's statements to the contrary, CR suspects some men might have slippage problems. When we placed the Avanti on a model of an average-sized penis, the condom could be pulled off quite easily. Since Avanti isn't latex, the label claims that any lubricant may be used safely. We cannot comment on the Avanti's strength. Because synthetic condoms are so new, researchers don't know how to compare their performance in standard tests against that of latex condoms.

Copyright Consumers Union of U.S., Inc., May 1995


Consumer Reports: How Reliable Are Condoms?
  1. http://cctr.umkc.edu/user/cgladish/faq/condom-faq.html
  2. http://sqzm14.ust.hk/condom-ratings-95.HTML
  3. http://sqzm14.ust.hk/purity-500.txt/condom-ratings-95.html
  4. http://www.cs.caltech.edu/~adam/INFO/condoms
  5. http://www.students.uiuc.edu/~dellenba/condomfaq.htm
  6. http://www.youth.org/news/0495/condoms.html

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