Table IV.

Examples of recommendations for rectal applicator improvement from Participants in Stage 1B¹

Size/Portability	Applicator not practical for carrying/ Make it thinner, maybe just a tube/ Easier to fit inside your jeans…like a condom or traveling size lube…you want something that is easy to take with you when you are out and about…you don’t want a product that is to be used at home only because it is too huge to carry around/ Make the plastic soft so a person can put it in his jeans pocket and won’t look like he is carrying a…/ The current applicator is so large it’s embarrassing to bring with me. I wouldn’t carry it around unless I know I will have sex with someone
Color	Change color to a brownish/ I would change the color of the applicator tip [cap] so that it wasn’t orange (it looks too much like a douche). I would make it a more neutral color so it would be more discreet in a bag/ Perhaps in a dark color/ What if it were black or red and a little sleeker.
Applicator Tip	For some reason, the tip causes pain during insertion [and] removal/ If the tip itself was lubricated [it is]/ It has too much point/ Maybe smoother…generally it’s ok but sometimes it felt like it was stabbing me/ The Fleet applicator isn’t the most comfortable; in this case something bigger would actually feel better/ Flexible would be better/ The nozzle has to be changed, to be able to apply gel to the sides, not only in the front direction
Looks/design	Make it sexier –and streamline the design to resemble a sex toy or prostate stimulator/ Make it in a fun, curvaceous container/ Make it so I could feel it up my rectum/ I am blessed to not be diabetic, but this feels as though I have one of those mechanisms in my pocket/ Make the applicator look more modern, it looks too much like Elmer’s glue/ The enema shape of the applicator is kind of a turn off. The shape of an enema draws up thoughts of constipation/ Publish specifications for the applicator and let the medical or sex toy industry come up with a design and worry more about the gel itself/ If you made the bottle clear with loud colors and made it so you can squeeze out certain amounts whenever you want that would be more attractive and effective/ Get rid of the plunger
Refillable?	Refillable is great for me, so I don’t have to have a million applicators. BUT I don’t know how guys would feel about using the same applicator over and over again…/ Definitely a refillable & reusable product would be ideal to make it a bit more environmentally friendly…/ With the whole tip getting messy from your bum (remnants of feces), I would recommend one time use only/ Refillable for use with a lover-disposable for use with one-night stands.
Process	The application process either more discrete or have it become a natural part of the sexual experience/ I ended up at times applying product on my fingers and then use it as any regular gel to apply on condom and on the front and walls of the rectum/
Product Packaging	Packaging needs to be more easily accessible. I had to use a sharp object every time/ One time broke the applicator while trying to open package/ Especially if you have lube on your hands. It is not pleasant to struggle with it/ I would change the product package to a more vibrant color
No applicator	Prefer no applicator and to use like lube/ I think the best solution would be to concentrate the gel enough so that only a small amount is required. Then it could be sold in a tube just like any other lubricant and people could apply it themselves/ What about making it in the form of a repository? [suppository?] That takes away the worry of carrying it around after use/ I love the gel but hate the applicator

¹Quotes are write-in responses from participants on CASI questionnaire at follow-up