Inserting the device properly may take practice. Especially problematic for gay men, the manufacturer, under FDA restrictions, provides instructions only for insertion into the vagina. Advocates recommend novice users have the top sinultaneously wear a regular condom until the bottom is confident he has the hang of insertion. Many questions remain. According to the manufactorer, the failure rate for properly installed Reality condoms is as low as that for standard condoms.
Independent tests indicate Reality's failure rate is in fact lower than standard condoms.
Regarding use by gay men, tests by San Francisco AIDS researcher Dr. Marcus Conant and two colleagues showed the material impermeable to both HIB and cytomegalovirus, but the team made no claims regarding failure rate. According to San Francisco gay newspaper the Bay Area Reporter, a study of gay male use conducted by the Howard Brown Memorial Clinic in Chicago revealed no reports of dislodgement and no rips or tears in the condoms after sex. Nonetheless without more conclusive studies regarding HIV prevention, experts recommend withdrawel prior to climax.