Petrelis Files

GLAAD's View of Anal Condoms and Gays;
Two Rebuttals

Last week, after I blogged about the FDA giving approval to a new version of the Reality female condom, a device that can and is used for anal sex, as barrier to HIV and STDs and pregnancy, I spoke with my friend Richard Ferraro in NYC who works as the spokesman for the Gay and Lesbian Alliance Against Defamation.

I asked him to have GLAAD issue an action alert over the news accounts on the FDA approval, because the reporters failed to mention Reality's role in stopping new HIV infections among gay men. He promised to look into the matter and get back to me, which he did yesterday.

Richard's reply disappointed me because GLAAD so narrowly focused on the federal agencies involved in researching and potentially promoting new HIV barriers, agencies not known for being gay-friendly nor actively looking for new ways to work with the gay community for better gay health.

It's so tiresome to see GLAAD not engaged in creative thinking either about recent Reality stories omitting gay men, or the need for more scientific studies on use of anal condoms during male-on-male sex. Has this group lost all urgency to promote better ways of stopping new gay HIV and STD infections? If GLAAD has, well, then it's not alone. Lots of gay and HIV/AIDS nonprofits are complacent about advocating for improved prevention methods.

Regardless of the studies or federal approval, the Stop AIDS Project of San Francisco, a group run by and for gay men, has long distributed the anal condom as an effective barrier to halting new anal transmission of HIV. The San Francisco Department of Public Health funds distribution of Reality through such groups, and also makes anal condoms available at city-run clinics.

If the Stop AIDS Project and the SF DPH can promote and hand out Reality to gays, it would be wise of GLAAD to speak with those organizations and work with them to renew attention on anal condoms and reinvigorating the debate about HIV prevention.

I shared Richard Ferraro's thoughtful reply with Thomas Kraemer, a gay scholar and researcher based in Oregon, who has tracked new developments in science-based HIV prevention on his blog. You can read his response after GLAAD's reply below.

Even though GLAAD is not mobilizing any resources about Reality and its coverage regarding gay men, I"m still pleased Richard wrote back because his reply is a small contribution to the debate about better HIV prevention for our community in the new century.

The reply from GLAAD:

Hi Michael,

As we always do, our Programs department researched this issue before determining if our media advocacy work is appropriate and spent a great deal of time doing so to ensure accuracy - which is cause for the delay in my reply to you.

The female condom is not approved by the FDA and clinical trials have been inconclusive. The FDA has included that “Female condoms are neither approved nor for anal sex, either for MSM or heterosexual women.” Studies that we reviewed conclude that there is difficulty inserting and keeping the female condom in place for men who have sex with men. Design modifications and trainings may be needed before MSM can use the product safely. The FDA, CDC and studies our Programs team reviewed conclude that without being educated on proper usage and without design modifications, the product at times can be dangerous. Media outlets rely on the work and official statements and stances of the FDA and CDC.

It would be a disservice to advocate that the media report on off-label use at this point. The education and instructions for proper use by men who have sex with men is not readily available and the studies we reviewed call for design modifications.

Please let me know if you have any additional questions.

Best, Rich

And here is the response from Thomas Kraemer:

Dear Michael,

GLAAD's concerns about the "female condom" being used for gay anal sex are well-known, but they ignore the underlying political problem that anti-gay policies of the Republicans and Bush administration eliminated funding of the research needed to adapt the "female condom" to be an FDA approved "anal condom" for HIV prevention among gay men.

Right now, most research efforts are being directed toward reducing heterosexual HIV-2 infections in Africa because of anti-gay Bush policies. Researchers are afraid of losing funding if they apply their work also to gay men in America.

Also, GLAAD is missing that the required FDA research studies on the "female condom" for anal sex were done in the 1990s, but the company did not have the financial resources to seek final FDA approval, especially given that sodomy was not legalized in the U.S. until 2003.

In fact, many gay men have been using the female condom despite the lack of FDA approval.

Other new alternatives needing research funding include PEG-ES enemas that can be used either by itself to reduce intestinal wall damage, or as a delivery mechanism for a rectal microbicide to prevent new HIV infections.

Where is the leadership needed to obtain research funding support for new methods, such as the "female condom" and PEG-ES enemas, to prevent HIV-1 infections from gay anal sex in America?

Best, Thomas

Thank you, Thomas, for not only discussing Reality with common sense, but for also calling attention to the other methods of unapproved ways to stop HIV in the gay community. We need more thinking like yours.