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Transforming the once-a-day pill for HIV prevention from medicine to empowering self-care using human-centred design in Zimbabwe
  1. Emily Lark Harris1,
  2. Katharine D Shelley2,
  3. Thenjiwe Sisimayi3,
  4. Catherine Wandie4,
  5. Cal Bruns4
  1. 1 Global Health, US Agency for International Development, Washington, DC, USA
  2. 2 PATH, Seattle, Washington, USA
  3. 3 Independent Consultant, Harare, Zimbabwe
  4. 4 Matchboxology, Johannesburg, South Africa
  1. Correspondence to Emily Lark Harris, Global Health, US Agency for International Development, Washington, DC 20547, USA; emharris{at}


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).

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Data availability statement

No data are available. Data sharing is not applicable as no datasets were generated and/or analysed for this study.

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Data availability statement

No data are available. Data sharing is not applicable as no datasets were generated and/or analysed for this study.

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  • Contributors All authors were involved substantially in all aspects of the product development work including the conception and design of the work; the acquisition, analysis or interpretation of data for the work; and drafting the work or revising it critically for important intellectual content. All authors provided final approval of the version to be published; and agree to be accountable for all aspects or integrity of any part of the work are appropriately investigated and resolved. ELH acts as the guarantor.

  • Funding V Zimbabwe was made possible by the support of the American people through the United States Agency for International Development (USAID) under the US President’s Emergency Plan for AIDS Relief (PEPFAR) through EngageDesign contract 7200AA18M00011 and EMOTION Cooperative Agreement AID-OAA-A-15-00033. V is a registered trademark of CONRAD.

  • Disclaimer The content of this supplement is solely the responsibility of the authors and does not necessarily represent the official views of USAID, or any other agency. The authors have no individual-level financial support to disclose.

  • Competing interests The lead author works for USAID, the donor funding the work. The contributing authors work for PATH as an employee and as an independent consultant and for Matchboxology. PATH—a global non-profit that improves health (—and Matchboxology, a global human-centered design firm based in South Africa (—are partners in EngageDesign.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.