Pre-exposure prophylaxis (PrEP) is an anti-HIV medication taken to help prevent HIV transmission to people who are HIV negative [1]. PrEP is currently approved through two routes of transmission, a daily oral pill or a bimonthly intramuscular injection [2, 3]. By taking PrEP once daily, it can decrease the risk of HIV transmission, even if exposed to the virus. PrEP is approved for open label use, meaning healthcare providers and the patients are aware of the treatment as prevention option and are making an informed decision to engage in its use [4]. The CDC guidelines for identifying substantial risk for acquiring HIV as eligible for daily oral PrEP use among sexually active adults and adolescents are: 1) anal or vaginal sex in the past six months AND any of the following: 1) HIV-positive sexual partners (especially if partner has an unknown or detectable viral load), 2) a bacterial sexually transmitted infection in the past 6 months, and/or 3) a history of inconsistent or no condom use with sexual partner (s)[5, 6].

PrEP effectively prevents HIV transmission by more than 90% when taken as recommended [1]. Yet, Houston, TX ranks 11th in the nation for HIV incidence rates, of which 36% were cisgender women, and 71% of those were Black women [7]. Behaviors that place individuals at high risk for acquiring HIV are common: 88% of Black women become HIV positive through condomless heterosexual sex [8], and substance use-related transmission rates are 13.4% for injection drug use and 32.1% for non-injection drug use [9]. Targeted interventions are needed to unlink the HIV risk of heterosexual sex and substance use among cisgender Black women. Meaningful progress towards ending the HIV epidemic plan include strategies that can extend health equity to cisgender Black women.