Real Experience: The Key to Vaginal Microbicide Acceptability

Objective: To determine whether acceptability of a vaginal microbicide is influenced more by initial attitudes about microbicides or experience with actual products.

Methods: As part of a Phase I Study of BufferGel, a novel vaginal microbicide, 27 low risk abstinent or monogamous women in Rhode Island responded to self-report questionnaires assessing acceptability of vaginal microbicides. Mean age of the women was 31 years; 63% were White, 15% Hispanic, 11% African American, and 11% Other. Acceptability data were collected at enrollment and after daily use of the product for four weeks. At the end of the study, women were asked about their willingness to try BufferGel if approved vaginal use. With no differences between abstinent and monogamous women on key variables, the data were combined for this analysis.

Results: At enrollment, women indicated that they would be more willing to try microbicides that are gels rather than creams. While the majority (85%) were moderately or very willing to try gels, 15% were only slightly willing. The women had no preference for reusable or disposable applicators. After using the product, 100% of the women indicated liking BufferGel’s color. Conversely, although 100% of the women indicated a willingness to use reusable applicators prior to the study, after experience with the reusable BufferGel applicator, 7 of these women reported not liking the applicator, particularly the fact that it had to be washed between uses. After daily use of BufferGel, 75% of the women said that they would use the microbicide if it were approved for vaginal use. This willingness was not related to any sociodemographic factors, or any attitudes or preferences assessed prior to use. This willingness was supported by a positive change in attitudes about clear gel after experience with the product. There was also a trend indicating that not being willing to use BufferGel is associated with reports of not liking reusable applicators, after having had experience with them.

Conclusions/Lessons Learned: Actual experience with vaginal microbicides rather than attitudes prior to use are associated with willingness to these products in the future. Strategies that encourage women to try these products are more likely to increase vaginal microbicide use than educational campaigns designed to change pre-existing attitudes.

Margaret Chesney
UCSF Prevention Science Group
74 New Montgomery
San Francisco, CA