title: Couples' acceptability of the SILCS diaphragm for microbicide delivery.
abstract: BACKGROUND
  Disposable plastic applicators used in microbicide gel studies are expensive and have a negative environmental impact. The SILCS diaphragm is a barrier contraceptive that could offer a reusable delivery system.
  
  
  METHODS
  Thirty-six couples in this randomized, cross-over study evaluated single- and double-sided gel delivery from a SILCS diaphragm compared with gel from an applicator. Couples used each gel scenario during two acts of intercourse and completed acceptability questionnaires after each.
  
  
  RESULTS
  All three scenarios received favorable ratings for ease of application, acceptability and perceived effectiveness. Both female and male participants tended to rate the gel applicator significantly more favorably than either SILCS gel delivery scenarios for all attributes except messiness/leakage and effectiveness. Additionally, about 60% of female participants and about half of male participants preferred the gel applicator to either of the gel delivery systems using SILCS. The preference for the SILCS scenario for pregnancy protection was statistically significant for both sexes. Male participants were also significantly more likely to prefer the SILCS single-sided delivery system to the gel applicator for protection from sexually transmitted infection.
  
  
  CONCLUSIONS
  In this study population, participants found the gel applicator to be more acceptable than either single- or double-sided gel delivery from a SILCS diaphragm. Further research of the SILCS as a microbicide delivery system should be implemented to assess its acceptability among study populations that reflect diverse potential user groups such as women and men from both low and high HIV prevalence settings including HIV-positive populations and with and without experience using female barrier methods.
authors: California Family Health Council, Los Angeles, CA 90010, USA.
authors: Ron G
authors: RG
authors: Frezieres
authors: Terri
authors: T
authors: Walsh
authors: Maggie
authors: M
authors: Kilbourne-Brook
authors: Patricia S
authors: PS
authors: Coffey
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D003274:Contraceptive Devices, Female; D018592:Cross-Over Studies; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D012959:Socioeconomic Factors; D014622:Vaginal Creams, Foams, and Jellies / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D014622:Vaginal Creams, Foams, and Jellies