Perceptions of the “Fabric” – An exploratory study of a novel multi-purpose technology among women in Sub Saharan Africa

Abstract

BackgroundHIV and pregnancy prevention are dual health priorities for women, and particularly in sub-Saharan Africa. Drug-eluting fibers offer a dosage form that combines HIV prevention and contraception, but early understanding of end-user perspectives is critical to avoid misalignment between products being developed and preferred product attributes.MethodsFocus group discussions (FGDs) were conducted in South Africa, Uganda and Zimbabwe, among 55 women who had used vaginal products in previous trials. Participants were given the opportunity to feel a sample of electrospun nanofiber (the fabric), see how it dissolves, and give feedback on shape, size and other attributes. Women were also asked to compare the fabric to vaginal gel and film.ResultsThree key themes regarding the acceptability of the fabric emerged: 1) look and feel of the product undissolved vs. undissolved, 2) expected effect on sex, and 3) convenience and ease of use. Upon being presented with the fabric, women were initially distrustful, seeing it as undesirable for vaginal insertion. Women generally approved of the product once they saw it dissolve. However, they stressed the importance of the product not interfering with sex by altering the vaginal environment. Women also reacted favorably to the perceived convenience of the fabric, particularly with regards to storage and transport, perceived ease of insertion and use, and dosing regimen.ConclusionMultipurpose prevention technologies, and nanofibers in particular, should be developed with an eye to minimizing impact on sex while maximizing convenience, and presented in such a way as to emphasize non-abrasiveness and ease of dissolution.

Pharmaceutical Vehicles for Vaginal and Rectal Administration of Anti-HIV Microbicide Nanosystems

“…Drug release is associated with fiber composition and structure and can be triggered by environmental changes pertinent to sexual intercourse, namely happening upon ejaculation (e.g., rising pH or the presence of components from semen) [116,117]. Depending on specific characteristics, namely concerning the ability to dissolve and the perception of which shape is easier to insert in the vagina, fiber mats appear to be well accepted by potential female users of microbicides [118].…”

“…Left —square (25 cm 2 ); center —circle (diameter = 5 cm); right —capped tube (length = 4 cm, diameter = 2 cm). Adapted from [118] under the terms of the Creative Commons Attribution License 4.0 (Copyright 2018 Laborde et al; doi:10.1371/journal.pone.0204821).…”

Medical Applications of Porous Biomaterials: Features of Porosity and Tissue‐Specific Implications for Biocompatibility

“…[18,80,81] Specifically, some of these applications include wound dressings, [82][83][84][85] vascular grafts, [86][87][88][89][90][91] and intravaginal dosage forms for antiretroviral drugs. [92][93][94][95][96][97][98][99] Additionally, this method is amendable to virtually any natural or synthetic polymer and can efficiently encapsulate physicochemically diverse pharmaceutical agents or growth factors. [81,100,101] Conventional spinning methods start from a solution composed of desired polymers, agents, and a volatile solvent, which is loaded into a positively charged syringe.…”

Electrospun fibers for vaginal administration of tenofovir disoproxil fumarate and emtricitabine in the context of topical pre-exposure prophylaxis

“…Preclinical data suggest that fibers allow achieving quick and extensive coverage of the vaginal epithelium, which could be crucial for providing effective protection from HIV-1 transmission [21]. Furthermore, an exploratory study conducted by performing focus group interviews found that fiber mats are likely to be well accepted by women for topical PrEP [22].…”