title: Acceptability of a bioadhesive nonoxynol-9 gel delivered by an applicator as a rectal microbicide.
abstract: OBJECTIVE
  Potential rectal microbicides, as an adjunct to condoms for HIV/STD prevention, have not been studied previously.
  
  
  OBJECTIVE
  Advantage 24 (1.5 ml of a bioadhesive gel containing 52.5 mg nonoxynol-9 administered by single-use applicator)-under investigation as a vaginal microbicide-was evaluated for acceptability among male couples.
  
  
  METHODS
  Twenty-five HIV-negative and 10 HIV-positive male couples participated in a frequency use escalation trial. Diaries and self-administered questionnaires assessed product use, acceptability, sexual behavior, and gastrointestinal and urologic side effects.
  
  
  RESULTS
  Excluding participants who felt no need for an HIV prevention method, 58% said they would use Advantage 24 if approved for rectal use; 69% of receptive users reported rectal fullness and related side effects after insertion of the gel, and 68% reported applicator-related discomfort; 59% of insertive participants found the gel too sticky.
  
  
  CONCLUSIONS
  Acceptability remains inconclusive and warrants further study of redesigned applicators and ways to minimize rectal side effects.
authors.affiliation: Abt Associates Inc., Bethesda, Maryland 20814, USA.
authors.forename: M
authors.initials: M
authors.lastname: Gross
authors.forename: C L
authors.initials: CL
authors.lastname: Celum
authors.forename: S R
authors.initials: SR
authors.lastname: Tabet
authors.forename: C W
authors.initials: CW
authors.lastname: Kelly
authors.forename: A S
authors.initials: AS
authors.lastname: Coletti
authors.forename: M A
authors.initials: MA
authors.lastname: Chesney
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D015658:HIV Infections / Q000517:prevention & control*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D017137:Nonoxynol / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D010349:Patient Compliance; D012007:Rectum; D012725:Sexual Behavior; D011795:Surveys and Questionnaires
chemical_list: D000890:Anti-Infective Agents; D017137:Nonoxynol