A Randomized Crossover Study Evaluating the Use and Acceptability of the SILCS Diaphragm Compared to Vaginal Applicators for Vaginal Gel Delivery

AIDS Behav. 2018 Jan;22(1):127-132. doi: 10.1007/s10461-017-1913-4.


Introduction: This study aimed to assess acceptability and preferences for the SILCS diaphragm for vaginal gel delivery compared to a prefilled applicator.

Methods: A randomized crossover study among 115 women in South Africa, using both methods during five sex acts.

Results: We found no significant differences in acceptability between the two products. Experience of gel leakage after sex was greater when inserted via applicator. More women were interested in SILCS/gel for multipurpose protection (68%) than in either SILCS alone (17%) or microbicide gel alone (14%).

Conclusions: A SILCS gel delivery system for multipurpose prevention seems feasible and acceptable.

Keywords: Barrier methods; Diaphragm; Gel; MPT; Multipurpose technology; Vaginal applicator.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Administration, Intravaginal
  • Adult
  • Anti-Infective Agents / administration & dosage*
  • Coitus
  • Contraception, Barrier / methods*
  • Contraceptive Devices, Female*
  • Cross-Over Studies
  • Diaphragm*
  • Drug Delivery Systems / instrumentation*
  • Drug Delivery Systems / methods
  • Female
  • HIV Infections / prevention & control
  • Humans
  • Middle Aged
  • Patient Acceptance of Health Care
  • South Africa
  • Treatment Outcome
  • Vaginal Creams, Foams, and Jellies / administration & dosage*
  • Young Adult


  • Anti-Infective Agents
  • Vaginal Creams, Foams, and Jellies