PrEP Is for Black Women, Too!
Pre-Exposure Prophylaxis (PrEP) for the Prevention of Human Immunodeficiency Virus (HIV)
Learning module activity
Published ____ 2026
A Module Course Designed for Health Care Providers Who Provide Health Care Services to Black Women
Intended Audience
This module activity is intended for use by prescribing clinicians; however, health care professionals involved in patient education may also benefit from the information and tools provided. This toolkit is intended as a guide for PrEP-naïve individuals. For complete guidance for patients newly starting, or previously taking, HIV PrEP, please refer to the PrEP clinical guidelines.
Language
Throughout this module activity, the term “women” specifically refers to Black cisgender women. This intentional focus is not meant to exclude transgender women, nonbinary individuals or others who may benefit from HIV prevention efforts but rather to highlight the urgent need to address the unique experiences, health disparities and structural inequities faced by Black cisgender women. Despite being disproportionately affected by HIV, this group is often overlooked in research, policy and clinical guidance. Centering Black cisgender women allows us to directly confront these gaps and provide tailored, affirming and impactful care strategies.
Disclosures
The development of this module activity is supported by grant funding issued by the Michigan Department of Health and Human Services (MDHHS).
No one involved in the development of this toolkit has a relevant financial relationship to disclose with an ineligible company. Brand names of medications are used within this toolkit solely for educational purposes.
Although this activity is designed to offer comprehensive guidance on delivering PrEP services to Black women, users are encouraged to consult full prescribing information and relevant clinical guidelines for additional context and detailed recommendations.
Introduction
Introduction
HIV PrEP is a powerful tool — but its power is only realized when it reaches the people who need it most. For Black women, that access remains far too limited. Despite clear evidence of PrEP’s effectiveness, and national guidelines recommending it for all sexually active individuals, many Black women are still left out of the conversation — and left vulnerable to HIV acquisition.
Black women are disproportionately impacted by HIV. In 2023, despite making up only 13% of the United States (US) population, Black women accounted for half of all new HIV diagnoses among heterosexual cisgender women nationwide. In Michigan alone, the HIV incidence rate among Black women was more than nine times higher than that of white women. This is not just a statistic. This is a call to action.
Barriers — such as stigma, lack of awareness, medical mistrust and systemic inequities — continue to limit PrEP access. But one of the most powerful tools to overcome those barriers is YOU.
As a health care provider, YOU can play a valuable role in changing the trajectory of HIV for Black women.
By integrating PrEP into your everyday practice, you are not just following evidence-based guidelines, but also showing your patients that they are seen, heard and valued.
This module activity, created in partnership with the Mahogany Blue campaign, was designed to support you in this effort. It's here to help you feel confident and equipped to talk about PrEP, prescribe it and ultimately help protect the health and futures of Black women in your care. This activity aims to empower clinicians to be proactive allies in closing the prevention gap for Black women and to promote equity, autonomy and PrEP access.
Mahogany Blue
The Mahogany Blue campaign presents an opportunity to promote PrEP utilization among Black women by decreasing stigma, medical mistrust, the lack of awareness about PrEP and insurance challenges. The campaign is dedicated to empowering women by recognizing the unique barriers Black women encounter in accessing HIV prevention tools like PrEP. Through heightened awareness, advocacy for research inclusive of stratified data for Black women and community engagement, MDHHS aims to implement meaningful change and ensure equitable health care access for all.
Mahogany Blue
The Mahogany Blue campaign is an adaptation of the Centers for Disease Control and Prevention’s (CDC) She's Well campaign, which is now a component of the CDC’s overall Let’s Stop HIV Together campaign. Mahogany is a nod to not only the various shades of Black women, but also the resiliency of Black women. “Blue” references PrEP medication that has traditionally been recognized as a blue pill. The campaign features Black women of various hues, shapes and ages in informational materials customized for Wayne County. While the original PrEP pill was blue in color, PrEP now comes in many colors and forms. Patients and providers can work together to determine the best form of PrEP for their needs.
The Burden of HIV Among Black Women
Black women continue to be disproportionately impacted by HIV, representing 50% of new HIV diagnoses among US women, despite comprising less than 13% of the female population. Their infection rate remains the highest among all racial and ethnic groups of women. This data highlight the critical role clinicians play in addressing social determinants of health, reducing stigma and ensuring equitable access to prevention, testing and treatment services.
To effectively support Black women in HIV prevention, it is critical that clinicians understand the structural and social drivers that heighten their vulnerability. Please take the time to click on each of the three topic icons below to learn more about these important concepts:
Medical Mistrust
Intersectionality
Structural Racism
Clinicians have a unique opportunity and critical responsibility to tailor HIV prevention in a way that validates these realities, fosters trust and centers the lived experiences of Black women.
The Burden of HIV Among Black Women in the US and the State of Michigan
Introduction
PrEP is the use of antiretroviral medications to prevent HIV acquisition among persons who could be exposed to HIV via sexual intercourse and/or the use of intravenous drugs. PrEP can reduce HIV acquisition through sex by 99% and from injection drug use by 74%. Despite a clear need, Black women continue to be underserved by HIV prevention strategies such as PrEP.
In 2024, women accounted for only 9% of PrEP users, an especially low proportion when compared with the 91% of users who were men. Data on PrEP uptake among Black women is even more limited, obscuring the true extent of this gap. This disparity reflects a critical missed opportunity to deliver effective HIV prevention to women, particularly Black women, who remain disproportionately affected by HIV in the U.S.
Understanding PrEP for HIV Prevention
Recommendation for Use
The U.S. Preventive Services Task Force provides a grade A recommendation encouraging clinicians to prescribe PrEP to individuals who are at increased vulnerability to HIV acquisition. Several options for PrEP are available for use in Black women.
Available PrEP Options for Use in Women
Important Note: Tenofovir alafenamide (TAF/FTC) [Brand name: Descovy] is a PrEP medication that is not currently FDA approved for use in cisgender women due to previously lacking efficacy data. However, studies are ongoing.According to the International Antiviral Society–USA (IAS–USA) Panel, a 2025 analysis showed an 89% reduction in HIV acquisition risk among cisgender women who had biomarker evidence of taking an average of at least two doses of tenofovir alafenamide/emtricitabine (TAF/FTC) per week. The PURPOSE 1 clinical trial demonstrated a strong link between TAF/FTC adherence and HIV protection. As a result, the IAS now recommends TAF/FTC for HIV prevention from vaginal exposure in individuals for whom tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) is either contraindicated or not preferred. Due to non-FDA approval, the use of TAF/FTC for HIV prevention in cisgender women is not covered in this toolkit. For more details, consult the IAS–USA guidelines and the full prescribing information for TAF/FTC.
PrEP is a powerful tool in the primary care toolkit — especially for supporting the health and well-being of Black women.
Despite facing unique social and structural challenges that increase their risk for HIV, Black women are too often left out of patient-provider discussions about PrEP. This gap in care contributes to ongoing disparities.
As health care providers, it is essential to view PrEP as a routine part of preventive care and not as a specialized or stigmatized intervention. All licensed health care providers are authorized to prescribe PrEP, yet many patients are unnecessarily referred to specialists, creating avoidable barriers to access.
By incorporating PrEP into everyday checkups, like blood pressure screenings or Pap smears, we can help normalize its use, reduce stigma and empower patients with more choices to protect their sexual health.
Tenofovir Disoproxil Fumarate and Emtricitabine (TDF/FTC) Brand name: Truvada
Dosage and dosing schedule
Type of medication
Duration of action
Side effects
Efficacy
Use in People Who Inject Drugs (PWID)
Use During Pregnancy and by Women of Childbearing Potential
Other considerations
Cost
Click here for more prescribing information:
Tenofovir Disoproxil Fumarate and Emtricitabine (TDF/FTC) Brand name: Truvada
Dosage and dosing schedule
Type of medication
Duration of action
Side effects
Efficacy
Use in People Who Inject Drugs (PWID)
Use During Pregnancy and by Women of Childbearing Potential
Other considerations
Cost
Click here for more prescribing information:
Tenofovir Disoproxil Fumarate and Emtricitabine (TDF/FTC) Brand name: Truvada
Dosage and dosing schedule
Type of medication
Duration of action
Side effects
Efficacy
Use in People Who Inject Drugs (PWID)
Use During Pregnancy and by Women of Childbearing Potential
Other considerations
Cost
Click here for more prescribing information:
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When discussing PrEP with Black women, health care providers should take a holistic and person-centered approach that considers the benefits, risks and limitations of each available option.
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The Burden of HIV Among Black Women
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Interactivity and animation can be your best allies when creating tables, infographics, or graphics that help provide context to information and simplify data for translation to your audience.
What you read: Interactivity and animation can turn the most boring content into something fun. At Genially, we use AI (Awesome Interactivity) in all our designs, so you can level up with interactivity and turn your content into something that adds value and engages.Our brain is biologically wired to process visual content. Almost 50% of our brain is involved in processing visual stimuli.
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The Burden of HIV Among Black Women
'Including citations always enhances our presentation.Breaks the monotony'
Black women are disproportionately impacted by HIV. In 2023, despite making up only 13% of the United States (US) population, Black women accounted for half of all new HIV diagnoses among heterosexual cisgender women nationwide. In Michigan alone, the HIV incidence rate among Black women was more than nine times higher than that of white women. This is not just a statistic. This is a call to action.
Black women are disproportionately impacted by HIV. In 2023, despite making up only 13% of the United States (US) population, Black women accounted for half of all new HIV diagnoses among heterosexual cisgender women nationwide. In Michigan alone, the HIV incidence rate among Black women was more than nine times higher than that of white women. This is not just a statistic. This is a call to action.
Subtitle
The Burden of HIV Among Black Women
Black women are disproportionately impacted by HIV. In 2023, despite making up only 13% of the United States (US) population, Black women accounted for half of all new HIV diagnoses among heterosexual cisgender women nationwide. In Michigan alone, the HIV incidence rate among Black women was more than nine times higher than that of white women. This is not just a statistic. This is a call to action.
Use timelines...
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PrEP With a Purpose
Black women deserve access to the full spectrum of HIV prevention tools, including PrEP. Health care providers are pivotal in making that access a reality.
As stewards of health and equity, you have the power to transform clinical spaces into affirming, inclusive environments where Black women feel seen, heard and protected.
This toolkit is more than a resource — it’s a call to action. By normalizing PrEP conversations, using reason-based and empowering language and addressing systemic barriers head-on, you help close the HIV prevention gap and affirm the dignity and autonomy of every Black woman in your care.
Your commitment to integrating PrEP into routine preventive care is not just a clinical best practice — it is an act of equity, advocacy and justice.
PrEP is for Black women, too, and together, we can ensure it becomes a trusted, accessible and empowering option for every woman who desires it.
The Burden of HIV Among Black Women
References
- Centers for Disease Control and Prevention. HIV Diagnoses, Deaths, and Prevalence: 2025 Update. HIV Data. Published April 29, 2025. https://www.cdc.gov/hiv-data/nhss/hiv-diagnoses-deaths-and-prevalence-2025.html
- AIDSVu. (2025, June 26). AIDSVu Releases 2024 PrEP Use Data Showing Growing Use Across the U.S. - AIDSVu. AIDSVu. https://aidsvu.org/news-updates/aidsvu-releases-2024-prep-use-data-showing-growing-use-across-the-u-s/
- Michigan Department of Health and Human Services. (2024). PrEP and black women. https://www.michigan.gov/mdhhs/keep-mi-healthy/chronicdiseases/hivsti/prep/prep-and-black-women
- Michigan Department of Health and Human Services. (2025). HIV Prevalence Report. https://www.michigan.gov/mdhhs/-/media/Project/Websites/mdhhs/Keeping-Michigan-Healthy/HIVSTI/Data-and-Statistics/2025/HIV-Prevalence-Report-Slides-2024.pdf
- Centers for Disease Control and Prevention (2022, July 6). HIV and Black/African American People in the U.S. https://stacks.cdc.gov/view/cdc/120030/cdc_120030_DS1.pdf
- United States Preventive Services Task Force. (2023). Preexposure Prophylaxis to Prevent Acquisition of HIV: US Preventive Services Task Force Recommendation Statement. The Journal of the American Medical Association, 330(8), 736–745. https://doi.org/10.1001/jama.2023.14461
- Landovitz, R. J., Molina, J.-M., Buchbinder, S. P., & International Antiviral Society-USA (IAS-USA) Panel. (2025). Preexposure prophylaxis for HIV: Updated recommendations from the 2024 international antiviral society-usa panel. JAMA. https://doi.org/10.1001/jama.2025.11410
- Gandhi, R. T., Landovitz, R. J., Sax, P. E., Smith, D. M., Springer, S. A., Günthard, H. F., Thompson, M. A., Bedimo, R. J., Benson, C. A., Buchbinder, S. P., Crabtree-Ramirez, B. E., Rio, C. del, Eaton, E. F., Eron, J. J., Hoy, J. F., Lehmann, C., Molina, J.-M., Jacobsen, D. M., & Saag, M. S. (2024). Antiretroviral drugs for treatment and prevention of HIV in adults: 2024 recommendations of the international antiviral society–USA panel. Journal of the American Medical Association, 333(7). https://doi.org/10.1001/jama.2024.24543
- Department of Health and Human Services. (2025, June 12). Recommendations for the use of antiretroviral drugs during pregnancy and interventions to reduce perinatal HIV transmission in the United States. https://clinicalinfo.hiv.gov/en/guidelines/perinatal/safety-toxicity-arv-agents-nrtis-tenofovir-disoproxil-fumarate-viread
- United States Public Health Service, Centers for Disease Control and Prevention (U.S.), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (U.S.). Division of HIV/AIDS Prevention, & Preexposure Prophylaxis Work Group. (2021, December). Preexposure prophylaxis for the prevention of HIV infection in the United States -- 2021 update: A clinical practice guideline. CDC Stacks. https://stacks.cdc.gov/view/cdc/112360
- New York State Department of Health AIDS Institute. (2025, February 7). Interim guideline on the use of twice-yearly lenacapavir for HIV prevention . https://www.hivguidelines.org/guideline/hiv-prep-len/?mytab=tab_5&mycollection=pep-prep#table-1
- ViiV Healthcare. (2021b). Risk to reasons. ViiV Healthcare. https://viivhealthcare.com/en-us/supporting-the-hiv-community/positive-action/risk-to-reasons/
- Johnson, R., Duroseau, B., Randolph, S., & Chandler, R. (2024). Reasons over risks: NPs and HIV prevention for Black women. The Journal for Nurse Practitioners, 20(3), 104931–104931. https://doi.org/10.1016/j.nurpra.2024.104931
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The Burden of HIV Among Black Women
Acknowledgements
This module activity was developed in collaboration with Brianna Kline, MSN, APRN, FNP-BC, AAHIVS, Kyra Sanders, MSW, and Tyffanie Walton, B.S.
Brianna Kline is a family nurse practitioner at the Wayne Health Detroit Public Health STD Clinic and serves as a Clinician Training Specialist with the Michigan site of the Midwest AIDS Education and Training Center (MATEC). She is deeply passionate about advancing HIV prevention for Black women, who face unique challenges and disproportionately high rates of HIV. Combining the power of education with culturally tailored care, Brianna believes these approaches are essential to closing prevention gaps. This toolkit is important to her because it equips health care providers with the knowledge and resources needed to confidently offer PrEP to Black women, improving access and outcomes in communities that need it most. Through her clinical and training work, Brianna aims to inspire providers to deliver compassionate care that uplifts and empowers every patient.
Kyra Sanders is the MDHHS Ending the HIV Epidemic community planner and co-creator of the Mahogany Blue campaign. Kyra is a seasoned public health expert with over 25 years of experience in HIV prevention and education. Her work centers on advancing equity, empowering people — with a special emphasis on Black women and shaping community‑driven health strategies across Michigan. Kyra turns knowledge into power and “good trouble” into lasting change.
Tyffanie Walton is the MDHHS Ending the HIV Epidemic community health educator and co-creator of the Mahogany Blue campaign. She is committed to advancing HIV prevention by centering the voices of Black women, challenging stigma and expanding access to PrEP. For her, this toolkit is more than a resource — it is a declaration that Black women deserve care rooted in dignity, equity and truth. At the same time, Tyffanie views this work as an act of justice for all communities, affirming that prevention is not a privilege but a right every person should be able to confidently claim.
The Burden of HIV Among Black Women
Describe the problem you are going to solve and, above all, why your idea is interesting
Describe the problem you are going to solve and, above all, why your idea is interesting
Describe the problem you are going to solve and, above all, why your idea is interesting
Remember to publish!
Use in People Who Inject Drugs (PWID)
Proved to be ~74% effective in preventing HIV among this population.
The Burden of HIV Among Black Women in Michigan
Geographically, the HIV epidemic remains most concentrated in the City of Detroit, which recorded a prevalence rate of 781.6 per 100,000 residents in 2024 — exceeding that of any other jurisdiction in the state by more than fourfold. Wayne, Oakland and Ingham County also exhibit markedly elevated rates, occupying positions among the top four most affected jurisdictions, while Macomb County ranks eleventh in terms of prevalence.
MDHHS HIV Prevalence Report, 2024
Side effects
Most common: nausea, headache. Less common: renal concerns, bone density loss.
Efficacy
99% prevention via sexual intercourse. 74% prevention via intravenous drug use with consistent daily dosing.
Intersectionality adds another layer of complexity to these challenges, as Black women face the combined impacts of racial, gender and socioeconomic marginalization. Their experiences are diverse, and prevention efforts that overlook this complexity risk perpetuating the very inequities they seek to eliminate.
Intersectionality
Duration of action
Approximately 24 hours, daily dosing required.
Use During Pregnancy and by Women of Childbearing Potential
FDA-approved and preferred for initiation before pregnancy, during pregnancy and while breastfeeding given the more robust safety and efficacy data available.
Cost
Approximately $30 per 30-day supply.
The Burden of HIV Among Black Women in the U.S.
Black women continue to be disproportionately impacted by HIV, representing 50% of new HIV diagnoses among US women, despite comprising less than 13% of the female population. This disparity underscores the urgent need for culturally responsive and equity-driven approaches in clinical care. Among Black women nationwide, 91% of new HIV infections are attributed to heterosexual contact. Their infection rate remains the highest among all racial and ethnic groups of women. This data highlight the critical role clinicians play in addressing social determinants of health, reducing stigma and ensuring equitable access to prevention, testing and treatment services.
HIV Diagnoses, Deaths, and Prevalence: 2025 Update
Medical mistrust — often perceived as patient reluctance — must be recognized as a rational response to a legacy of racialized harm in health care, from historical abuses like the Tuskegee Syphilis Study to ongoing disparities in treatment, pain management and maternal care.
Medical Mistrust
Dosage and dosing schedule
A single tablet of 200 mg emtricitabine/300 mg TDF taken once daily.Self-administered by patient.
Type of medication
Oral tablet (taken by mouth).
Other considerations
Lower cost, well-studied.
Structural racism is the system-wide embedding of racial inequality in institutions, policies and practices that disadvantage some groups while privileging others. It permeates nearly every aspect of daily life — limiting access to quality health care, affordable housing, stable employment and preventive services like PrEP. These barriers are not accidental but rooted in policies, institutional practices and systems of care that disproportionately harm Black communities.
Structural racism
The Burden of HIV Among Black Women in Michigan
HIV prevalence in Michigan demonstrates profound racial and geographic disparities, with Black/African American communities bearing the highest burden. According to 2024 data, Black women in Michigan have an HIV prevalence rate of 340.3 per 100,000 residents making them 15 times more likely to be living with HIV than white women, who have a rate of just 22.5 per 100,000 residents. Black women also experience higher HIV diagnosis rates, with a diagnosis rate of 8.9 per 100,000 residents making them almost nine times more likely to be diagnosed with HIV than white women, who have a rate of just 0.9 per 100,000 residents. This disparity draws light to the systemic barriers Black women often face in accessing HIV prevention, testing, and treatment services.
MDHHS HIV Prevalence Report, 2024
Use in People Who Inject Drugs (PWID)
Proved to be ~74% effective in preventing HIV among this population.
Side effects
Most common: nausea, headache. Less common: renal concerns, bone density loss.
Efficacy
99% prevention via sexual intercourse. 74% prevention via intravenous drug use with consistent daily dosing.
Duration of action
Approximately 24 hours, daily dosing required.
Use During Pregnancy and by Women of Childbearing Potential
FDA-approved and preferred for initiation before pregnancy, during pregnancy and while breastfeeding given the more robust safety and efficacy data available.
Cost
Approximately $30 per 30-day supply.
Dosage and dosing schedule
A single tablet of 200 mg emtricitabine/300 mg TDF taken once daily.Self-administered by patient.
Type of medication
Oral tablet (taken by mouth).
Other considerations
Lower cost, well-studied.
Side effects
Most common: nausea, headache. Less common: renal concerns, bone density loss.
Use in People Who Inject Drugs (PWID)
Proved to be ~74% effective in preventing HIV among this population.
Efficacy
99% prevention via sexual intercourse. 74% prevention via intravenous drug use with consistent daily dosing.
Type of medication
Oral tablet (taken by mouth).
Use During Pregnancy and by Women of Childbearing Potential
FDA-approved and preferred for initiation before pregnancy, during pregnancy and while breastfeeding given the more robust safety and efficacy data available.
Dosage and dosing schedule
A single tablet of 200 mg emtricitabine/300 mg TDF taken once daily.Self-administered by patient.
Cost
Approximately $30 per 30-day supply.
Other considerations
Lower cost, well-studied.
Duration of action
Approximately 24 hours, daily dosing required.
Intersectionality adds another layer of complexity to these challenges, as Black women face the combined impacts of racial, gender and socioeconomic marginalization. Their experiences are diverse, and prevention efforts that overlook this complexity risk perpetuating the very inequities they seek to eliminate.
Intersectionality
Intersectionality adds another layer of complexity to these challenges, as Black women face the combined impacts of racial, gender and socioeconomic marginalization. Their experiences are diverse, and prevention efforts that overlook this complexity risk perpetuating the very inequities they seek to eliminate.
Intersectionality
Intersectionality adds another layer of complexity to these challenges, as Black women face the combined impacts of racial, gender and socioeconomic marginalization. Their experiences are diverse, and prevention efforts that overlook this complexity risk perpetuating the very inequities they seek to eliminate.
Intersectionality
Intersectionality adds another layer of complexity to these challenges, as Black women face the combined impacts of racial, gender and socioeconomic marginalization. Their experiences are diverse, and prevention efforts that overlook this complexity risk perpetuating the very inequities they seek to eliminate.
Intersectionality
Intersectionality adds another layer of complexity to these challenges, as Black women face the combined impacts of racial, gender and socioeconomic marginalization. Their experiences are diverse, and prevention efforts that overlook this complexity risk perpetuating the very inequities they seek to eliminate.
Intersectionality
We are able to understand images from millions of years ago, even from other cultures.
We have thousands and thousands of stories. Two-thirds of our conversations are stories.
We need to interact with each other. We learn collaboratively.
We have thousands and thousands of stories. Two-thirds of our conversations are stories.
We need to interact with each other. We learn collaboratively.
We are able to understand images from millions of years ago, even from other cultures.
We are able to understand images from millions of years ago, even from other cultures.
We have thousands and thousands of stories. Two-thirds of our conversations are stories.
We need to interact with each other. We learn collaboratively.
We are able to understand images from millions of years ago, even from other cultures.
We have thousands and thousands of stories. Two-thirds of our conversations are stories.
We need to interact with each other. We learn collaboratively.
Communicate
Showing enthusiasm, giving a smile, and maintaining eye contact with your audience can be your best allies when it comes to telling stories that excite and pique the interest of the public: 'The eyes, chico. They never lie'. This will help you make a connection with your audience. Leave them speechless!
Structure
When carrying out a presentation, two objectives must be pursued: conveying information and avoiding yawns. To achieve this, it may be a good practice to create an outline and use words that engrave in the minds of your audience.
Surprise
Interactivity and animation can be your best allies when creating tables, infographics, or graphics that help provide context to information and simplify data for translation to your audience.We are visual beings and find it easier to 'read' images than written text.
Structure
When carrying out a presentation, two objectives must be pursued: conveying information and avoiding yawns. To achieve this, it may be a good practice to create an outline and use words that engrave in the minds of your audience.
Plan
What you read: interactivity and animation can make the most boring content fun. At Genially, we use AI (Awesome Interactivity) in all our designs, so you can level up with interactivity and turn your content into something that adds value and engages.
Design
If you want to provide additional information or develop the content in more detail, you can do so through your oral presentation.We recommend that you practice your voice and rehearse: the best improvisation is always the most worked!
Communicate
Showing enthusiasm, giving a smile, and maintaining eye contact with your audience can be your best allies when it comes to telling stories that excite and pique the interest of the public: 'The eyes, chico. They never lie'. This will help you make a connection with your audience. Leave them speechless!
PrEP Is for Black Women, Too!
Brianna Kline
Created on April 6, 2026
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Transcript
PrEP Is for Black Women, Too!
Pre-Exposure Prophylaxis (PrEP) for the Prevention of Human Immunodeficiency Virus (HIV)
Learning module activity
Published ____ 2026
A Module Course Designed for Health Care Providers Who Provide Health Care Services to Black Women
Intended Audience
This module activity is intended for use by prescribing clinicians; however, health care professionals involved in patient education may also benefit from the information and tools provided. This toolkit is intended as a guide for PrEP-naïve individuals. For complete guidance for patients newly starting, or previously taking, HIV PrEP, please refer to the PrEP clinical guidelines.
Language
Throughout this module activity, the term “women” specifically refers to Black cisgender women. This intentional focus is not meant to exclude transgender women, nonbinary individuals or others who may benefit from HIV prevention efforts but rather to highlight the urgent need to address the unique experiences, health disparities and structural inequities faced by Black cisgender women. Despite being disproportionately affected by HIV, this group is often overlooked in research, policy and clinical guidance. Centering Black cisgender women allows us to directly confront these gaps and provide tailored, affirming and impactful care strategies.
Disclosures
The development of this module activity is supported by grant funding issued by the Michigan Department of Health and Human Services (MDHHS).
No one involved in the development of this toolkit has a relevant financial relationship to disclose with an ineligible company. Brand names of medications are used within this toolkit solely for educational purposes.
Although this activity is designed to offer comprehensive guidance on delivering PrEP services to Black women, users are encouraged to consult full prescribing information and relevant clinical guidelines for additional context and detailed recommendations.
Introduction
Introduction
HIV PrEP is a powerful tool — but its power is only realized when it reaches the people who need it most. For Black women, that access remains far too limited. Despite clear evidence of PrEP’s effectiveness, and national guidelines recommending it for all sexually active individuals, many Black women are still left out of the conversation — and left vulnerable to HIV acquisition.
Black women are disproportionately impacted by HIV. In 2023, despite making up only 13% of the United States (US) population, Black women accounted for half of all new HIV diagnoses among heterosexual cisgender women nationwide. In Michigan alone, the HIV incidence rate among Black women was more than nine times higher than that of white women. This is not just a statistic. This is a call to action.
Barriers — such as stigma, lack of awareness, medical mistrust and systemic inequities — continue to limit PrEP access. But one of the most powerful tools to overcome those barriers is YOU.
As a health care provider, YOU can play a valuable role in changing the trajectory of HIV for Black women.
By integrating PrEP into your everyday practice, you are not just following evidence-based guidelines, but also showing your patients that they are seen, heard and valued.
This module activity, created in partnership with the Mahogany Blue campaign, was designed to support you in this effort. It's here to help you feel confident and equipped to talk about PrEP, prescribe it and ultimately help protect the health and futures of Black women in your care. This activity aims to empower clinicians to be proactive allies in closing the prevention gap for Black women and to promote equity, autonomy and PrEP access.
Mahogany Blue
The Mahogany Blue campaign presents an opportunity to promote PrEP utilization among Black women by decreasing stigma, medical mistrust, the lack of awareness about PrEP and insurance challenges. The campaign is dedicated to empowering women by recognizing the unique barriers Black women encounter in accessing HIV prevention tools like PrEP. Through heightened awareness, advocacy for research inclusive of stratified data for Black women and community engagement, MDHHS aims to implement meaningful change and ensure equitable health care access for all.
Mahogany Blue
The Mahogany Blue campaign is an adaptation of the Centers for Disease Control and Prevention’s (CDC) She's Well campaign, which is now a component of the CDC’s overall Let’s Stop HIV Together campaign. Mahogany is a nod to not only the various shades of Black women, but also the resiliency of Black women. “Blue” references PrEP medication that has traditionally been recognized as a blue pill. The campaign features Black women of various hues, shapes and ages in informational materials customized for Wayne County. While the original PrEP pill was blue in color, PrEP now comes in many colors and forms. Patients and providers can work together to determine the best form of PrEP for their needs.
The Burden of HIV Among Black Women
Black women continue to be disproportionately impacted by HIV, representing 50% of new HIV diagnoses among US women, despite comprising less than 13% of the female population. Their infection rate remains the highest among all racial and ethnic groups of women. This data highlight the critical role clinicians play in addressing social determinants of health, reducing stigma and ensuring equitable access to prevention, testing and treatment services.
To effectively support Black women in HIV prevention, it is critical that clinicians understand the structural and social drivers that heighten their vulnerability. Please take the time to click on each of the three topic icons below to learn more about these important concepts:
Medical Mistrust
Intersectionality
Structural Racism
Clinicians have a unique opportunity and critical responsibility to tailor HIV prevention in a way that validates these realities, fosters trust and centers the lived experiences of Black women.
The Burden of HIV Among Black Women in the US and the State of Michigan
Introduction
PrEP is the use of antiretroviral medications to prevent HIV acquisition among persons who could be exposed to HIV via sexual intercourse and/or the use of intravenous drugs. PrEP can reduce HIV acquisition through sex by 99% and from injection drug use by 74%. Despite a clear need, Black women continue to be underserved by HIV prevention strategies such as PrEP.
In 2024, women accounted for only 9% of PrEP users, an especially low proportion when compared with the 91% of users who were men. Data on PrEP uptake among Black women is even more limited, obscuring the true extent of this gap. This disparity reflects a critical missed opportunity to deliver effective HIV prevention to women, particularly Black women, who remain disproportionately affected by HIV in the U.S.
Understanding PrEP for HIV Prevention
Recommendation for Use
The U.S. Preventive Services Task Force provides a grade A recommendation encouraging clinicians to prescribe PrEP to individuals who are at increased vulnerability to HIV acquisition. Several options for PrEP are available for use in Black women.
Available PrEP Options for Use in Women
Important Note: Tenofovir alafenamide (TAF/FTC) [Brand name: Descovy] is a PrEP medication that is not currently FDA approved for use in cisgender women due to previously lacking efficacy data. However, studies are ongoing.According to the International Antiviral Society–USA (IAS–USA) Panel, a 2025 analysis showed an 89% reduction in HIV acquisition risk among cisgender women who had biomarker evidence of taking an average of at least two doses of tenofovir alafenamide/emtricitabine (TAF/FTC) per week. The PURPOSE 1 clinical trial demonstrated a strong link between TAF/FTC adherence and HIV protection. As a result, the IAS now recommends TAF/FTC for HIV prevention from vaginal exposure in individuals for whom tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) is either contraindicated or not preferred. Due to non-FDA approval, the use of TAF/FTC for HIV prevention in cisgender women is not covered in this toolkit. For more details, consult the IAS–USA guidelines and the full prescribing information for TAF/FTC.
PrEP is a powerful tool in the primary care toolkit — especially for supporting the health and well-being of Black women.
Despite facing unique social and structural challenges that increase their risk for HIV, Black women are too often left out of patient-provider discussions about PrEP. This gap in care contributes to ongoing disparities.
As health care providers, it is essential to view PrEP as a routine part of preventive care and not as a specialized or stigmatized intervention. All licensed health care providers are authorized to prescribe PrEP, yet many patients are unnecessarily referred to specialists, creating avoidable barriers to access.
By incorporating PrEP into everyday checkups, like blood pressure screenings or Pap smears, we can help normalize its use, reduce stigma and empower patients with more choices to protect their sexual health.
Tenofovir Disoproxil Fumarate and Emtricitabine (TDF/FTC) Brand name: Truvada
Dosage and dosing schedule
Type of medication
Duration of action
Side effects
Efficacy
Use in People Who Inject Drugs (PWID)
Use During Pregnancy and by Women of Childbearing Potential
Other considerations
Cost
Click here for more prescribing information:
Tenofovir Disoproxil Fumarate and Emtricitabine (TDF/FTC) Brand name: Truvada
Dosage and dosing schedule
Type of medication
Duration of action
Side effects
Efficacy
Use in People Who Inject Drugs (PWID)
Use During Pregnancy and by Women of Childbearing Potential
Other considerations
Cost
Click here for more prescribing information:
Tenofovir Disoproxil Fumarate and Emtricitabine (TDF/FTC) Brand name: Truvada
Dosage and dosing schedule
Type of medication
Duration of action
Side effects
Efficacy
Use in People Who Inject Drugs (PWID)
Use During Pregnancy and by Women of Childbearing Potential
Other considerations
Cost
Click here for more prescribing information:
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When discussing PrEP with Black women, health care providers should take a holistic and person-centered approach that considers the benefits, risks and limitations of each available option.
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The Burden of HIV Among Black Women
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The Burden of HIV Among Black Women
'Including citations always enhances our presentation.Breaks the monotony'
Black women are disproportionately impacted by HIV. In 2023, despite making up only 13% of the United States (US) population, Black women accounted for half of all new HIV diagnoses among heterosexual cisgender women nationwide. In Michigan alone, the HIV incidence rate among Black women was more than nine times higher than that of white women. This is not just a statistic. This is a call to action.
Black women are disproportionately impacted by HIV. In 2023, despite making up only 13% of the United States (US) population, Black women accounted for half of all new HIV diagnoses among heterosexual cisgender women nationwide. In Michigan alone, the HIV incidence rate among Black women was more than nine times higher than that of white women. This is not just a statistic. This is a call to action.
Subtitle
The Burden of HIV Among Black Women
Black women are disproportionately impacted by HIV. In 2023, despite making up only 13% of the United States (US) population, Black women accounted for half of all new HIV diagnoses among heterosexual cisgender women nationwide. In Michigan alone, the HIV incidence rate among Black women was more than nine times higher than that of white women. This is not just a statistic. This is a call to action.
Use timelines...
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PrEP With a Purpose
Black women deserve access to the full spectrum of HIV prevention tools, including PrEP. Health care providers are pivotal in making that access a reality.
As stewards of health and equity, you have the power to transform clinical spaces into affirming, inclusive environments where Black women feel seen, heard and protected.
This toolkit is more than a resource — it’s a call to action. By normalizing PrEP conversations, using reason-based and empowering language and addressing systemic barriers head-on, you help close the HIV prevention gap and affirm the dignity and autonomy of every Black woman in your care.
Your commitment to integrating PrEP into routine preventive care is not just a clinical best practice — it is an act of equity, advocacy and justice.
PrEP is for Black women, too, and together, we can ensure it becomes a trusted, accessible and empowering option for every woman who desires it.
The Burden of HIV Among Black Women
References
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The Burden of HIV Among Black Women
Acknowledgements
This module activity was developed in collaboration with Brianna Kline, MSN, APRN, FNP-BC, AAHIVS, Kyra Sanders, MSW, and Tyffanie Walton, B.S.
Brianna Kline is a family nurse practitioner at the Wayne Health Detroit Public Health STD Clinic and serves as a Clinician Training Specialist with the Michigan site of the Midwest AIDS Education and Training Center (MATEC). She is deeply passionate about advancing HIV prevention for Black women, who face unique challenges and disproportionately high rates of HIV. Combining the power of education with culturally tailored care, Brianna believes these approaches are essential to closing prevention gaps. This toolkit is important to her because it equips health care providers with the knowledge and resources needed to confidently offer PrEP to Black women, improving access and outcomes in communities that need it most. Through her clinical and training work, Brianna aims to inspire providers to deliver compassionate care that uplifts and empowers every patient.
Kyra Sanders is the MDHHS Ending the HIV Epidemic community planner and co-creator of the Mahogany Blue campaign. Kyra is a seasoned public health expert with over 25 years of experience in HIV prevention and education. Her work centers on advancing equity, empowering people — with a special emphasis on Black women and shaping community‑driven health strategies across Michigan. Kyra turns knowledge into power and “good trouble” into lasting change.
Tyffanie Walton is the MDHHS Ending the HIV Epidemic community health educator and co-creator of the Mahogany Blue campaign. She is committed to advancing HIV prevention by centering the voices of Black women, challenging stigma and expanding access to PrEP. For her, this toolkit is more than a resource — it is a declaration that Black women deserve care rooted in dignity, equity and truth. At the same time, Tyffanie views this work as an act of justice for all communities, affirming that prevention is not a privilege but a right every person should be able to confidently claim.
The Burden of HIV Among Black Women
Describe the problem you are going to solve and, above all, why your idea is interesting
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Remember to publish!
Use in People Who Inject Drugs (PWID)
Proved to be ~74% effective in preventing HIV among this population.
The Burden of HIV Among Black Women in Michigan
Geographically, the HIV epidemic remains most concentrated in the City of Detroit, which recorded a prevalence rate of 781.6 per 100,000 residents in 2024 — exceeding that of any other jurisdiction in the state by more than fourfold. Wayne, Oakland and Ingham County also exhibit markedly elevated rates, occupying positions among the top four most affected jurisdictions, while Macomb County ranks eleventh in terms of prevalence.
MDHHS HIV Prevalence Report, 2024
Side effects
Most common: nausea, headache. Less common: renal concerns, bone density loss.
Efficacy
99% prevention via sexual intercourse. 74% prevention via intravenous drug use with consistent daily dosing.
Intersectionality adds another layer of complexity to these challenges, as Black women face the combined impacts of racial, gender and socioeconomic marginalization. Their experiences are diverse, and prevention efforts that overlook this complexity risk perpetuating the very inequities they seek to eliminate.
Intersectionality
Duration of action
Approximately 24 hours, daily dosing required.
Use During Pregnancy and by Women of Childbearing Potential
FDA-approved and preferred for initiation before pregnancy, during pregnancy and while breastfeeding given the more robust safety and efficacy data available.
Cost
Approximately $30 per 30-day supply.
The Burden of HIV Among Black Women in the U.S.
Black women continue to be disproportionately impacted by HIV, representing 50% of new HIV diagnoses among US women, despite comprising less than 13% of the female population. This disparity underscores the urgent need for culturally responsive and equity-driven approaches in clinical care. Among Black women nationwide, 91% of new HIV infections are attributed to heterosexual contact. Their infection rate remains the highest among all racial and ethnic groups of women. This data highlight the critical role clinicians play in addressing social determinants of health, reducing stigma and ensuring equitable access to prevention, testing and treatment services.
HIV Diagnoses, Deaths, and Prevalence: 2025 Update
Medical mistrust — often perceived as patient reluctance — must be recognized as a rational response to a legacy of racialized harm in health care, from historical abuses like the Tuskegee Syphilis Study to ongoing disparities in treatment, pain management and maternal care.
Medical Mistrust
Dosage and dosing schedule
A single tablet of 200 mg emtricitabine/300 mg TDF taken once daily.Self-administered by patient.
Type of medication
Oral tablet (taken by mouth).
Other considerations
Lower cost, well-studied.
Structural racism is the system-wide embedding of racial inequality in institutions, policies and practices that disadvantage some groups while privileging others. It permeates nearly every aspect of daily life — limiting access to quality health care, affordable housing, stable employment and preventive services like PrEP. These barriers are not accidental but rooted in policies, institutional practices and systems of care that disproportionately harm Black communities.
Structural racism
The Burden of HIV Among Black Women in Michigan
HIV prevalence in Michigan demonstrates profound racial and geographic disparities, with Black/African American communities bearing the highest burden. According to 2024 data, Black women in Michigan have an HIV prevalence rate of 340.3 per 100,000 residents making them 15 times more likely to be living with HIV than white women, who have a rate of just 22.5 per 100,000 residents. Black women also experience higher HIV diagnosis rates, with a diagnosis rate of 8.9 per 100,000 residents making them almost nine times more likely to be diagnosed with HIV than white women, who have a rate of just 0.9 per 100,000 residents. This disparity draws light to the systemic barriers Black women often face in accessing HIV prevention, testing, and treatment services.
MDHHS HIV Prevalence Report, 2024
Use in People Who Inject Drugs (PWID)
Proved to be ~74% effective in preventing HIV among this population.
Side effects
Most common: nausea, headache. Less common: renal concerns, bone density loss.
Efficacy
99% prevention via sexual intercourse. 74% prevention via intravenous drug use with consistent daily dosing.
Duration of action
Approximately 24 hours, daily dosing required.
Use During Pregnancy and by Women of Childbearing Potential
FDA-approved and preferred for initiation before pregnancy, during pregnancy and while breastfeeding given the more robust safety and efficacy data available.
Cost
Approximately $30 per 30-day supply.
Dosage and dosing schedule
A single tablet of 200 mg emtricitabine/300 mg TDF taken once daily.Self-administered by patient.
Type of medication
Oral tablet (taken by mouth).
Other considerations
Lower cost, well-studied.
Side effects
Most common: nausea, headache. Less common: renal concerns, bone density loss.
Use in People Who Inject Drugs (PWID)
Proved to be ~74% effective in preventing HIV among this population.
Efficacy
99% prevention via sexual intercourse. 74% prevention via intravenous drug use with consistent daily dosing.
Type of medication
Oral tablet (taken by mouth).
Use During Pregnancy and by Women of Childbearing Potential
FDA-approved and preferred for initiation before pregnancy, during pregnancy and while breastfeeding given the more robust safety and efficacy data available.
Dosage and dosing schedule
A single tablet of 200 mg emtricitabine/300 mg TDF taken once daily.Self-administered by patient.
Cost
Approximately $30 per 30-day supply.
Other considerations
Lower cost, well-studied.
Duration of action
Approximately 24 hours, daily dosing required.
Intersectionality adds another layer of complexity to these challenges, as Black women face the combined impacts of racial, gender and socioeconomic marginalization. Their experiences are diverse, and prevention efforts that overlook this complexity risk perpetuating the very inequities they seek to eliminate.
Intersectionality
Intersectionality adds another layer of complexity to these challenges, as Black women face the combined impacts of racial, gender and socioeconomic marginalization. Their experiences are diverse, and prevention efforts that overlook this complexity risk perpetuating the very inequities they seek to eliminate.
Intersectionality
Intersectionality adds another layer of complexity to these challenges, as Black women face the combined impacts of racial, gender and socioeconomic marginalization. Their experiences are diverse, and prevention efforts that overlook this complexity risk perpetuating the very inequities they seek to eliminate.
Intersectionality
Intersectionality adds another layer of complexity to these challenges, as Black women face the combined impacts of racial, gender and socioeconomic marginalization. Their experiences are diverse, and prevention efforts that overlook this complexity risk perpetuating the very inequities they seek to eliminate.
Intersectionality
Intersectionality adds another layer of complexity to these challenges, as Black women face the combined impacts of racial, gender and socioeconomic marginalization. Their experiences are diverse, and prevention efforts that overlook this complexity risk perpetuating the very inequities they seek to eliminate.
Intersectionality
We are able to understand images from millions of years ago, even from other cultures.
We have thousands and thousands of stories. Two-thirds of our conversations are stories.
We need to interact with each other. We learn collaboratively.
We have thousands and thousands of stories. Two-thirds of our conversations are stories.
We need to interact with each other. We learn collaboratively.
We are able to understand images from millions of years ago, even from other cultures.
We are able to understand images from millions of years ago, even from other cultures.
We have thousands and thousands of stories. Two-thirds of our conversations are stories.
We need to interact with each other. We learn collaboratively.
We are able to understand images from millions of years ago, even from other cultures.
We have thousands and thousands of stories. Two-thirds of our conversations are stories.
We need to interact with each other. We learn collaboratively.
Communicate
Showing enthusiasm, giving a smile, and maintaining eye contact with your audience can be your best allies when it comes to telling stories that excite and pique the interest of the public: 'The eyes, chico. They never lie'. This will help you make a connection with your audience. Leave them speechless!
Structure
When carrying out a presentation, two objectives must be pursued: conveying information and avoiding yawns. To achieve this, it may be a good practice to create an outline and use words that engrave in the minds of your audience.
Surprise
Interactivity and animation can be your best allies when creating tables, infographics, or graphics that help provide context to information and simplify data for translation to your audience.We are visual beings and find it easier to 'read' images than written text.
Structure
When carrying out a presentation, two objectives must be pursued: conveying information and avoiding yawns. To achieve this, it may be a good practice to create an outline and use words that engrave in the minds of your audience.
Plan
What you read: interactivity and animation can make the most boring content fun. At Genially, we use AI (Awesome Interactivity) in all our designs, so you can level up with interactivity and turn your content into something that adds value and engages.
Design
If you want to provide additional information or develop the content in more detail, you can do so through your oral presentation.We recommend that you practice your voice and rehearse: the best improvisation is always the most worked!
Communicate
Showing enthusiasm, giving a smile, and maintaining eye contact with your audience can be your best allies when it comes to telling stories that excite and pique the interest of the public: 'The eyes, chico. They never lie'. This will help you make a connection with your audience. Leave them speechless!