'Educating, demystifying, destigmatising': Black women's perspectives on effective PrEP messaging in the USA

Black cisgender women in the USA are disproportionately affected by HIV but remain underrepresented in HIV-related pre-exposure prophylaxis (PrEP) messaging. Despite PrEP's efficacy in preventing HIV, uptake among Black cisgender in the USA women remains low. This qualitative study explored how PrEP messaging can better resonate with Black women's interests and needs by focusing on their experiences and preferences. We conducted semi-structured interviews with 30 Black cisgender women in the Midwest region of the USA between October and December 2022, capturing a diverse sample (US-born, African-born, and first-generation women of African descent). Thematic analysis developed four key themes: (1) the need for culturally tailored PrEP messaging strategies; (2) the importance of an empowering, inclusive tone and language; (3) challenging the perception that current PrEP advertising is primarily aimed at men who have sex with men and transgender women; and (4) the vital role of trusted voices, particularly Black women and community leaders, in promoting PrEP. Participants stressed that hearing about PrEP from individuals who share their racial, cultural, and gender identities would increase their comfort and engagement. Public health initiatives should prioritise culturally specific messaging that reflects Black women's lived experiences in the USA to reduce HIV disparities and promote equitable PrEP access.