Table 3.
Exemplar quotes from study participants across acceptability domains and factors
| Domains | Factors | Quotes |
|---|---|---|
| Application associated factors | Clarity of instructions (application & usability) | I: How clear were the instructions with applying and inserting the gel? P: Very clear. There were diagrams I: Ok. And the diagrams were simple to understand and everything? P: Right. So, if someone can’t read very well, they’ll still pretty much get it I: When they said something, do you remember when they said P: They gave me instructions on how to use the gel I: Did you ask them any questions? P: Not really |
| Ease of application (application & usability) | I: So, can you tell me about your experiences with inserting the gel over the seven day period? P: Yea, sure. It was easy. I will say the only thing I had a issue with was that like I wasn’t sure sometimes if it was in, if the gel was applied at the a region or like depth that I needed it to, or that I got all the gel out. Like you insert the applicator and released it in there but like it would be more helpful if the applicator was clear so maybe you could see like the contents and how much you needed, like how much was in there. I couldn’t really; I didn’t know how much gel was in the applicator so even when I put it into the rectum…I wasn’t sure like, was that a lot? Was that a little? Was it all gone? Is it not there? I: The next part will be your experience with gel insertion and direct observation therapy. How did you feel about the clinic staff member inserting the gel into your body? P: Other people might not know the angle of inserting the gel. There was one staff member who did it for me and she knew how to do it. The process was then painless. There were then some staff members who did not know the angle, so it was hurting a bit. However, it was not like an unbearable pain or anything like that. I was able withstand it. I think of all the time that I had the gel inserted, I felt hurt only once. As for having others putting it in, I didn’t feel embarrassed about it. Overall, I felt nothing when they inserted the gel |
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| Use-associated factors | Desirable/appealing elements of use (future use) | I: Can you tell me about why would you be extremely likely to use the gel in the future? P: I can just be like honest and crass and whatnot? I: Yeah P: Because that to me seems like the best alternative to just not using a condom. So like I personally don’t like using condoms, so when you tell me that there is a gel that kind of does the actual work, or can do the actual work, of my just guesswork (laughs). Then that to me is even more reassuring and it gives me a greater sense of confidence. Now if I were someone who already used, who did use condoms as frequently as maybe I should, then that would be like a straight up, like 100% yes I’ll do it, because like it’s, it’d be extremely safe, like in addition to me already using condoms, right? But as someone who doesn’t really prefer to use them, it’s like imagine being someone who doesn’t use condoms and hearing this information… “Oh, well there is something that still helps in prevention, etc. that isn’t a condom and that bypasses that, then like, oh my god, absolutely.” I: At the beginning of the study, you mentioned that if there were a similar rectal gel available that provided some protection against HIV, would it be likely for you to use the gel? P: I think it’s an alternative. I can use this gel along with a condom. I would feel more confident when I have sex I: You mentioned that it would be likely that you would use the gel. Now you’ve used the gel for 7 days. Has that opinion changed? P: It’s still the same. Nothing changed I: You mentioned that if it could protect against HIV to some extent, it would be likely for you to use this product. What would it be likely for you to use the gel? P: It’s added assurance. Let’s say I can use it with a boyfriend. I trust this person, so I can use this gel for protection without using a condom. But, it would be only with a boyfriend only that I will be confident to only use this gel. It’s a level of protection |
| Leakage (side-effects) | I: And after the, after the gel was inside, how was the feeling? You mention there wasn’t anything but do um once it was inside and kind of you were walking over to the other place, how did it, did you feel anything? P: Yeah, I initially had a feeling. I was going to ask my nurse: “I feel that it’s leaking..”, but I think because of the consistency, I thought it has to leak. It was not so thick and so I didn’t mention to nurse about the leakage but that’s it I mean, I didn’t feel uncomfortable with the gel I: Now we will talk about your experience using the study gel. Did you have trouble using the gel? P: I didn’t have any diarrhea or any stomachache. I didn’t feel uncomfortable. I only feel pain a bit when they inserted the gel. That’s pretty much it. It doesn’t leak or making the area around (the insertion area) dirty |
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| Vehicle associated factors | Texture/viscosity (gel characteristics) | I: Do you think this study gel has any advantages that perhaps you didn’t think about it before? You mentioned that it didn’t leak. Does the study gel have any other advantage? P: I think that they might adjust the viscosity or something along that line. In the beginning after the insertion, I imagined the gel to be clear and it might leak. After they pulled out the suppository, it didn’t leak. I think that they have improved on it I: How do you mean? Comparing to what? P: I’m talking about other gels in the market, other products. Gels that I use normally are sticky. They’re icky. I don’t feel that the area is dirty that I have wash it off. I feel clean afterwards I: Being one the few people who have actually used the product, could you talk about the consistency a little bit? P: The one thing I did like about it is once I finally got it in there, there was no… Once I got it in there, you didn’t feel anything sloshing around or anything like that. It was in there and I forgot about it. Other than the fact that I knew I put it in there, I forgot about. There is nothin’ goin’ on in there to let you know that there’s some gel in there, and that’s one thing I really really liked about it is you could put it in there and you could go on, you could forget about it. There was definitely no seepage, no leakage, which I really liked. So, it was a really good consistency to me |