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Shying away from protection

Step into the smallish restroom at Planned Parenthood in Tampa, and your nose almost scrapes the grim statistics tacked to the wall.

"Sex now leading HIV cause in women," one headline blares. "Women may become No. 1 AIDS target," warns another.

Out in the waiting room, the news is no better. The walls of wisdom remind women that they contract sexually transmitted diseases more easily than men. That fewer than one-third of sexually active men between 20 and 39 reported using a condom over a four-week survey period. That health authorities think about 1-million people carry the virus that causes AIDS.

Can a date with Reality change any of this?

It's too soon to know. So far, women have been reluctant to embrace Reality, the only female condom on the American market. Since making its debut at Planned Parenthood in November, Reality has remained tucked in the bottom of a locked file cabinet, unclaimed by the very women expected to snap it up.

"I'm not sure if it's because of the cost or because they're unfamiliar with it or because they don't like it," said Kathy Herrmann, Planned Parenthood's area director.

Probably some or all of the above.

Approved by the Food and Drug Administration last May, the Reality condom won't be in stores until spring. It's an odd-looking device that resembles a traditional condom crossed with a miniature windsock. At $5 for a three-pack at Planned Parenthood, it costs more than many women can pay, particularly when compared with the cost of traditional condoms.

But Herrmann and others anticipate the unfamiliarity with Reality will fade, especially once the manufacturer, Wisconsin Pharmacal, blitzes the public with an information and advertising campaign and once the product is more readily available.

"I expect as women become more familiar with it and as they become more educated about disease control, the use and demand will increase," Herrmann said.

Like traditional condoms, Reality is designed for one-time use. It can be inserted a couple of hours before it is needed. Constructed of polyurethane, as opposed to latex, it provides "a thin and very strong material that transmits heat and is very resistant to rips and tears," said Holly Sherman, a spokeswoman for Wisconsin Pharmacal.

"It's very natural. A man doesn't have to do anything other than use it correctly," Sherman said. "It's not constricting to a man, and the woman hardly feels it."

A list of outlets that provide Reality was not available, but Sherman said almost 300 public health and family planning clinics around the country have ordered it and are spreading the word to their clients about what it is and how it works.

Though many women are still shy about trying this method, three-quarters of those who gave it a chance said they liked the product and would use it again; 80 percent of the men concurred, Sherman said.

"You have to get used to anything that's new," she said. "Imagine what it was like when the diaphragm first came out."

Sherman hopes the product will be the protective method of preference for women who are already comfortable with using a female barrier method or who are sexually active but are unsure of their partner's history.

"For a lot of women, (the female condom) will be the choice. It adds a new alternative, a new weapon in the battle against AIDS and other STDs (sexually transmitted diseases)," she said.

"This was designed specifically to prevent the transmission of disease. The beauty of it is for the first time since the onset of the AIDS crisis, there is a new alternative under a woman's control with which she can protect herself. She doesn't have to ask a man in the heat of the moment to stop and put something on."

When it approved the condom last spring, the FDA did so with stipulations.

It required the product label to include the 26 percent annual pregnancy rate, a high figure that was, the FDA said, "believed to have been the result of improper use of the device."

Sherman said the failure rate was based on typical use, which reflects a rather casual approach to protection.

"It's important to point out the difference between typical use _ which means not necessarily using it with every sex act and not necessarily using it correctly _ and perfect use," she said.

Printed information released by Wisconsin Pharmacal compares Reality's 13 percent pregnancy rate over six months to the 8 percent rate attributed with use of latex condoms for men.

The comparable rate of pregnancy with other barrier methods is 10 percent for cervical caps, 8 percent for diaphragms and 12 percent for contraceptive sponges, none of which prevent disease.

Surprisingly, disease prevention is not often a main concern of women seeking birth control devices from Planned Parenthood. Most of the clients, women in their early 20s, still favor birth control pills over other contraceptive methods and think STDs are other people's problems, Herrmann said.

"They understand birth control pills. They know they're not going to get pregnant if they take them every day on time," she said.

"We still have women say, "Oh no, I only go out with nice boys.'


Herrmann's face crinkles.

"People do not have a tattoo on their forehead that says: "I've got a sexually transmittable diseases. I'm contagious.' "