title: The Promise of Intravaginal Rings for Prevention: User Perceptions of Biomechanical Properties and Implications for Prevention Product Development.
abstract: Intravaginal rings (IVRs) are currently under investigation as devices for the delivery of agents to protect against the sexual transmission of HIV and STIs, as well as pregnancy. To assist product developers in creating highly acceptable rings, we sought to identify characteristics that intravaginal ring users consider when making decisions about ring use or non-use. We conducted four semi-structured focus groups with 21 women (aged 18-45) who reported using an IVR in the past 12 months. Participants manipulated four prototype rings in their hands, discussed ring materials, dimensionality, and "behavior," and shared perceptions and appraisals. Five salient ring characteristics were identified: 1) appearance of the rings' surfaces, 2) tactile sensations of the cylinder material, 3) materials properties, 4) diameter of the cylinder, and 5) ring circumference. Pliability (or flexibility) was generally considered the most important mechanical property. Several ring properties (e.g., porousness, dimensionality) were associated with perceptions of efficacy. Women also revealed user behaviors that may impact the effectiveness of certain drugs, such as removing, rinsing and re-inserting the ring while bathing, and removing the ring during sexual encounters. As product developers explore IVRs as prevention delivery systems, it is critical to balance product materials and dimensions with use parameters to optimize drug delivery and the user experience. It is also critical to consider how user behaviors (e.g., removing the ring) might impact drug delivery.
authors.affiliation: Centers for Behavioral & Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, United States of America.|Department of Psychiatry & Human Behavior, The Warren Alpert Medical School, Brown University, Providence, Rhode Island, United States of America.|Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America.
authors.forename: Kate
authors.initials: K
authors.lastname: Morrow Guthrie
authors.affiliation: Centers for Behavioral & Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, United States of America.|Department of Psychiatry & Human Behavior, The Warren Alpert Medical School, Brown University, Providence, Rhode Island, United States of America.
authors.forename: Sara
authors.initials: S
authors.lastname: Vargas
authors.affiliation: Centers for Behavioral & Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, United States of America.
authors.forename: Julia G
authors.initials: JG
authors.lastname: Shaw
authors.affiliation: Centers for Behavioral & Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, United States of America.|Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America.
authors.forename: Rochelle K
authors.initials: RK
authors.lastname: Rosen
authors.affiliation: Centers for Behavioral & Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, United States of America.|Department of Psychiatry & Human Behavior, The Warren Alpert Medical School, Brown University, Providence, Rhode Island, United States of America.
authors.forename: Jacob J
authors.initials: JJ
authors.lastname: van den Berg
authors.affiliation: Department of Bioengineering, University of Utah, Salt Lake City, Utah, United States of America.
authors.forename: Patrick F
authors.initials: PF
authors.lastname: Kiser
authors.affiliation: ImQuest BioSciences, Frederick, Maryland, United States of America.
authors.forename: Karen
authors.initials: K
authors.lastname: Buckheit
authors.affiliation: Centers for Behavioral & Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, United States of America.
authors.forename: Dana
authors.initials: D
authors.lastname: Bregman
authors.affiliation: Centers for Behavioral & Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, United States of America.
authors.forename: Lara
authors.initials: L
authors.lastname: Thompson
authors.affiliation: Centers for Behavioral & Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, United States of America.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Jensen
authors.affiliation: Department of Bioengineering, University of Utah, Salt Lake City, Utah, United States of America.
authors.forename: Todd
authors.initials: T
authors.lastname: Johnson
authors.affiliation: ImQuest BioSciences, Frederick, Maryland, United States of America.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Buckheit
mesh_terms: D000293:Adolescent; D000328:Adult; D003274:Contraceptive Devices, Female; D016503:Drug Delivery Systems; D005260:Female; D015658:HIV Infections / Q000517:prevention & control; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy