Transforming the once-a-day pill for HIV prevention from medicine to empowering self-care using human-centred design in Zimbabwe

Objective For adolescent girls and young women (AGYW) in sub-Saharan Africa, oral tenofovir‐based pre‐exposure prophylaxis (commonly referred to as PrEP) provides a user-controlled HIV prevention method, critical to addressing their HIV risk and unmet prevention needs. Addressing the gap between clinical and real-world PrEP efficacy requires new approaches, such as ‘V’. ‘V’ reframes PrEP from medicine to self-care that is as easy to use as a young women’s favourite fashion or beauty brand. This article describes how human-centred design (HCD) was used to adapt the ‘V’ brand and service delivery strategy for implementation in Zimbabwe from its development via formative research in South Africa. Methods Following literature review, stakeholder analysis and landscaping, the ‘V’ brand and service delivery strategy were assessed through participatory immersion sessions with 152 participants in four Zimbabwe districts. Insights were synthesised across learning questions: What do AGYW and health workers think about ‘V’?; Which of the ‘V’ materials are most acceptable and relevant for Zimbabwe?; What adaptations are necessary for the selected ‘V’ materials for Zimbabwe?; and How should the selected ‘V’ assets be integrated? Results The ‘V’ innovative design principles—delightfully bold branding, a discreet starter kit and user-friendly materials that put young women in control of educating others—remained resonant. Feasible modifications were identified to adapt the ‘V’ brand and service delivery strategy to suit the local context. Conclusion ‘V’ delivers a ‘delightfully discreet’ approach that puts AGYW in charge of preventing HIV. The resonance of the core ‘V’ design concepts demonstrates how HCD can be applied to reframe PrEP as a product category (ie, from a stigmatising medicine to empowering self-care).