The daily pill asks a lot. We asked young Black women what they'd prefer instead.

Think about what daily oral PrEP actually demands: remember a pill every single day, keep the bottle somewhere safe, have an answer ready if someone asks what it's for. For young Black women in the South — who carry a heavy share of new HIV diagnoses — that's a lot to ask, and uptake shows it.

So we asked 75 Black women, ages 18 to 34, in Atlanta, Baton Rouge, and Jackson: if you could prevent HIV without a daily pill, what would you pick? We walked them through three options: a long-acting shot, a skin implant, and a vaginal ring that prevents both HIV and pregnancy.

The ring won — and lost. It was the most preferred and the most rejected. A two-for-one deal is compelling until it isn't; bodies and preferences differ, and women had strong feelings both ways.

The quiet consensus pick was the shot. Second most preferred, least rejected. In and out, nothing to remember, nothing visible. The implant? Mostly a no — too invasive for most.

Here's what I take from this: stop asking "which product" and start asking "which products," plural. There's no single winner here, and that's the point. Choice is the intervention.

And one more thing the interviews made clear: how you introduce a new option matters as much as the option itself. People wanted details, plain-language instructions, a chance to learn by doing, and to hear from peers — not a pamphlet. If we're serious about closing these gaps, young Black women need to be in the room designing the rollout, not just receiving it.

The paper: Denson, D. J., Tesfaye, C. L., Glusberg, D., et al. (2025). Assessing non-oral PrEP alternatives among young Black women in the Southern USA. Journal of Racial and Ethnic Health Disparities, 13, 505–516. https://doi.org/10.1007/s40615-024-02263-y