Designing Pleasure-Centered, Culturally Relevant PrEP Messaging for Black Gay, Bisexual, Queer, Same-Gender-Loving, and Other Men Who have Sex with Men (SGL/MSM) in New York City.

Culturally tailored, community-informed media can enhance pre-exposure prophylaxis (PrEP) awareness and acceptance among Black gay, bisexual, queer, same-gender-loving, and other men who have sex with men (Black SGL/MSM). To inform the development of a health campaign to increase PrEP utilization, we conducted four focus groups with Black SGL/MSM (N = 20) between February and June 2023. Discussions explored participants' perceptions of and engagement with HIV prevention messaging, with particular attention to strategies for redesigning campaigns to reduce PrEP-related stigma. Participants articulated preferences that clustered within three interrelated domains of effective PrEP messaging: content, delivery, and context. Within the content domain, participants emphasized the need for practical, actionable information (e.g., dosing options, visual demonstrations, and adherence support), alongside sex-positive and empowering narratives that reframed HIV prevention around pleasure, intimacy, and self-care rather than fear. Participants also called for destigmatization and normalization of PrEP by positioning it as a responsible, routine component of sexual wellness. Within the delivery domain, participants favored social media-driven formats, particularly strategies leveraging influencers, humor, and storytelling to enhance engagement and relatability. Within the context domain, participants prioritized authentic representation of Black queer communities through inclusive imagery, culturally resonant cues, and rejection of stereotypes, while also acknowledging structural and logistical realities such as competing priorities, privacy concerns, and the need for discreet, accessible messaging. PrEP messaging must move beyond traditional public health narratives by pairing clear "how-to" guidance with culturally concordant, sex-positive, and stigma-reducing strategies to improve PrEP relevance, awareness, and uptake.Trial registry NCT06785376.