Table V.

Examples of recommendations for vaginal applicator improvement for its rectal use from Participants in Stage 2¹

Size/Portability	Make it smaller/ More portable
Color	I like the color/ Perhaps because of the color, the applicator reminded me of a tampon; the applicator could be a more distinguishable color.
Applicator Tip	It’s sharp, though I’m aware the tip is designed for women/ [Make] pre-lubricated applicator tip/ Tip was wider and needed more lube.
Looks/design	Make it in fun colors with pictures/ A place for the pointer and middle finger to have to hold the applicator when administering the gel/ The two pieces should just be connected so I don’t lose the plunge stick/ Ideally a green product for the environment; maybe in the shape of a penis would make it fun and enjoyable.
Process	Make the applicator less sensitive; if I was not careful, the gel would have leaked before it was inside the rectum/ Sometimes, when I finished applying the gel, there was some gel left in the tip of the applicator, so I think the right amount of gel was not being applied the way it should.
Product Packaging	Maybe use a small hard case that’s more thin and less “prescription drug” looking/ Can be a tight wrap around he applicator itself.
No applicator	Make it like individual lubricants that come in pouches

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