Formative Development of a Sex-Positive Animated eHealth Video to Promote Pre-exposure prophylaxis (PrEP) Among Young...

Young Black women (YBW) remain disproportionately affected by HIV, yet awareness and uptake of pre-exposure prophylaxis (PrEP) remain low due to multilevel barriers and ineffective health communication. This formative qualitative intervention development study aimed to identify barriers and facilitators to PrEP engagement among young Black women aged 18-25 living in New York City and to translate these insights into the design of a culturally grounded, sex-positive eHealth video intervention. Two exploratory focus groups (N = 13) examined individual, interpersonal, and structural/contextual influences on PrEP attitudes and use. Guided by Black Feminist Thought, the Theory of Triadic Influence, and the Information-Motivation-Behavioral Skills model, findings were systematically translated into design objectives and content strategies using intervention mapping. Entertainment-education principles informed the development of Put Yourself First, a culturally concordant five-minute animated video. Participants emphasized the need for clear, practical PrEP education (e.g., dosing, side effects, reversibility) paired with transparent and actionable access information (e.g., cost support, confidentiality, and feasible, low-burden access pathways). Participants also highlighted the importance of sex-positive messaging that centers self-care, autonomy, and pleasure, and authentic representation and peer-based "homegirl intervention" dialogue to enhance credibility, reduce stigma, and normalize PrEP within everyday relationship contexts. Collectively, these findings highlight core narrative and content design priorities for culturally responsive PrEP communication for YBW. The resulting video provides a potentially scalable, community-informed approach to delivering PrEP information through engaging digital storytelling. Next steps include assessing feasibility and acceptability and exploring dissemination through digital and community-based channels.