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

In Brief 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.