Colour, fragrance and size: exploring women's preferences around design characteristics of drug-releasing vaginal rings

Introduction: Drug-releasing vaginal rings are widely marketed for contraception and hormone replacement therapy, and a raft of new experimental devices – including an antiretroviral-releasing ring for HIV prevention – are currently undergoing clinical or regulatory evaluation.
Objectives: To increase user acceptability of rings product and in turn enhance adherence and efficacy, we apply the principles of user-centred design to assess women’s needs, preferences and expectations for key design characteristics of silicone elastomer vaginal rings.

Methods: Drug-free silicone elastomer vaginal rings having different sizes, colours and fragrances were manufactured, and women’s preferences assessed through three focus group discussions (FGDs) conducted in eThekwini, South Africa. Some, but not all, of the women had previous experience of using vaginal products. Groups of up to six women were given the vaginal ring devices to evaluate.

Results: A total of 16 women aged 20–34 years of age participated in the FGDs. Opinions on ring colour were varied, with some women clearly preferring coloured products while for others this was not an important attribute. Similarly, participants had varied preferences for the different fragrances and intensity of fragrance. Concerns about colour and fragrance were linked to perceptions of vaginal health and safety related to chemical composition. There was more agreement on preferred vaginal ring size; flexibility and width were considered important factors for insertion and comfort with use.

Conclusion: Choice and options in sexual and reproductive health products facilitates increased choice and overall uptake.