Hair Appointments and HIV Prevention Come Together in New Program

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 in College Park shows how a community-designed program centered in Black-owned beauty shops in Baltimore was able to effectively deliver crucial information about HIV prevention to underserved women.  

Published Oct. 26 in the Journal of the International AIDS Society, the study shows how involving trusted community businesses 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 in women despite making up only 13% of the female population. 

Uptake of pre-exposure prophylaxis (PrEP) — medication that can prevent HIV infection — remains low among all women. Limited awareness, medical mistrust, stigma and the effects of gendered racism can all influence access to HIV prevention services. 

The researchers’ program, Tea Talk, took a new approach: Baltimore-area beauty industry professionals collaborated with 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,” said Stephen B. Thomas, professor of health policy and management and founder of Health Advocates In-Reach and Research (HAIR) Network at the School of Public Health.

“Beauty professionals are not simply a channel for health messages. They are community experts,” he said. “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 from March through June 2025 with tea and snacks, attention-grabbing posters with connections to local resources and pertinent educational materials. All of it was informed by the research team’s work with beauty shop participants to explore client experiences and identify the challenges surrounding HIV prevention specific to their communities. 

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 kinds of 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, study PI, assistant professor of medicine and medical director of UMSOM’s 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 setup, which served as a conversation starter, were major contributors to the success of Tea Talk,” said Spicyn. 

Clients accessed the program’s PrEP informational website 62 times during this period 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. 

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.