What if a conversation about HIV prevention began not in a doctor's office, but in a neighborhood beauty salon?
A new study led by the University of Maryland School of Medicine (UMSOM) in Baltimore and the University of Maryland School of Public Health (UMD SPH) in College Park shows how a community-designed program, Tea Talk, centered in Black-owned beauty shops in Baltimore, was able to effectively deliver crucial information about HIV prevention to underserved women.
Published October 26 in the Journal of the International AIDS Society, the study shows how involving trusted community business people can make sexual health education more accessible, culturally responsive and relevant to the women it aims to reach.
Black women continue to experience a disproportionate burden of HIV in the United States – accounting for half of HIV diagnoses despite making up only 13% of the female population. Uptake of pre-exposure prophylaxis (PrEP)—medication that can prevent HIV acquisition—remains low among all women. Limited awareness, medical mistrust, stigma and the effects of gendered racism can all influence access to HIV prevention services.
Tea Talk took a new approach: Baltimore-area beauty industry professionals collaborated with UMD virologists from UMSOM’s Institute of Human Virology and public health experts from SPH to design a program specifically addressing the barriers faced by Black women in the area.
When we call Black women ‘hard to reach,’ we overlook how often our systems fail to show up in places where trust already lives.
Dr. Stephen B. Thomas
Professor and founder of Health Advocates In-Reach and Research (HAIR) Network
“When we call Black women ‘hard to reach,’ we overlook how often our systems fail to show up in places where trust already lives,” said Dr. Stephen B. Thomas, professor of health policy and management and founder of Health Advocates In-Reach and Research (HAIR) Network at the UMD SPH.
“Beauty professionals are not simply a channel for health messages: They are community experts. Tea Talk was built with them, so prevention education could be relevant and connected to resources women can use.”
Tea Talk was piloted in six beauty shops over three months, from March through June 2025. During this period, clients accessed the program’s PrEP informational website 62 times through shop-specific QR codes. Beauty professionals reported strong interest among clients in sharing educational and prevention materials with others.
The study also documented a shift in beauty shop participants' understanding of PrEP, broadening their perceptions of who could benefit from HIV prevention medication and recognizing its relevance to Black women in particular.
Using a human-centered design process, the research team worked with beauty shop participants to explore client experiences and identify the challenges surrounding HIV prevention specific to their communities. This data informed how Tea Talk was implemented.
Tea Talk trained beauty professionals on sexual health knowledge including sexually transmitted infections, gender inclusivity and biomedical HIV prevention strategies, strengthening their confidence as community educators.
Beauty professionals trained researchers on what visually engaging but discreet materials could spark curiosity without explicitly displaying potentially stigmatizing references to HIV or PrEP. This allowed conversations to develop naturally through existing relationships between beauty professionals and their clients.
"As a medical community, we are sometimes quick to rush in and focus on what is of interest to us,” said Natalie Spicyn, MD, MHS, study PI and medical director of the JACQUES Initiative.
"We learned a lot from the communication expertise of the beauty professionals. They told the research team 'This poster looks good, but take HIV off of it, take PrEP off of it.' The importance of colorful but discreet materials, along with a welcoming tea set up which served as a conversation starter, were major contributors to the success of Tea Talk,” said Spicyn.
While the pilot did not measure changes in PrEP uptake or HIV incidence, the findings suggest that community-designed interventions offer a valuable way to expand the reach of prevention education and address social and structural barriers to care.
Learn more about Tea Talk: https://jacques.umaryland.edu/teatalk/
The University of Maryland (UMD) is the state's flagship university driven by a community of more than 50,000 fearless Terrapins. As a leading research university and top 20 public institution, UMD is proud to be part of the Association of American Universities. Dedicated to excellence and impact for the public good, the university is propelled by a $1.4 billion joint research enterprise. UMD is the nation’s first Do Good campus, and is consistently ranked for its innovation, research and top-tier academic programs. Located in the National Capital Region, the university offers an unparalleled student experience with federal internship opportunities, hundreds of academic programs and study abroad options, and top-ranked living-learning programs. Spurred by a culture of innovation and creativity, UMD’s faculty are global leaders in their fields and include Nobel laureates, Pulitzer Prize winners and members of the national academies. For more information about the University of Maryland, College Park, visit umd.edu.