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Microbicide Applicators: Understanding Design Preferences Among Women in the Dominican Republic and South Africa

Cohen, Jessica A. MHS*; Steele, Matthew S. PhD*; Ureña, Francisco I. Cáceres PhD; Beksinska, Mags E. MSc

Sexually Transmitted Diseases: January 2007 - Volume 34 - Issue 1 - p 15-19
doi: 10.1097/01.olq.0000218877.92778.fe

Objectives: The objectives of this study were to prioritize applicator design attributes among women in the Dominican Republic and South Africa, and to determine how preferences differed based on sociodemographic variables.

Goal: The goal was to identify acceptable microbicide applicator designs in 2 low-resource settings.

Study Design: We surveyed 895 women, randomly sampled from clinics in the Dominican Republic (n = 449) and South Africa (n = 446), with questions on sociodemographics, applicator attribute preferences, and price/design tradeoffs.

Results: Single-use design was the most valued attribute, and reusable design and low price were the least valued attributes in both populations. Preference for single-use design was associated with concern about reusable applicators spreading germs, secondary or higher education, older age, having children, and perception of moderate to high HIV risk.

Conclusions: Acceptability factors related to microbicide delivery mechanisms should continue to be evaluated among potential microbicide users to directly inform product development and introduction of microbicides.

A study in the Dominican Republic and South Africa found that women preferred single-use applicators over reusable applicators for microbicide delivery. This preference was strongly associated with concern about spreading germs with reusable applicators.

From *PATH, Seattle, Washington; the †Institute of Population and Development Studies (IPDS) at Profamilia, Santo Domingo, Dominican Republic; and the ‡Reproductive Health and HIV Research Unit (RHRU), Durban, South Africa

The authors thank Profamilia and RHRU study coordinators Germania Estévez and Simphiwe Zondi, as well as PATH study assistant Greg Zwisler, for their work in implementing this study. Many thanks also to Janet Vail, PATH study advisor, for her guidance throughout this study process.

This research was funded under the HealthTech intravenously program funded by the U.S. Agency for International Development/USAID Cooperative Agreement No. GPH-A-00-01-00005-00.

The views expressed in this article do not necessarily reflect the views of USAID.

Correspondence: Jessica A. Cohen, MHS, 1455 NW Leary Way, Seattle, WA 98107. E-mail:

Received for publication October 24, 2005, and accepted March 6, 2006.

© Copyright 2007 American Sexually Transmitted Diseases Association