case study:

Montefiore PrEP

Dealing with HIV transmission awareness head-on.


427 New Yorkers ages 13 to 24 years newly diagnosed with HIV in 2017. Among this group, 59% were among young black and Latino cisgender MSM (men who have sex with men). While PrEP has been around for years, only a small portion of those at high risk for HIV infection use it. The main reasons are fear of side effects, misinformation about effectiveness, and worry about the high cost. The campaign’s aim was to draw their attention and convince them to start using PrEP or visit a clinic to learn more about it.

We pride ourselves at Zebra Strategies in our ability to reach underserved or marginalized populations. Our research, conducted over a year-long period, involved surveys, in-depth interviews, exploratory focus groups, and message testing. Our work focused on YMCSM (young men of color who have sex with men) and YTWC (young transgender women of color). We aimed to create a deeper understanding of the challenges faced by this often misrepresented, misunderstood demographic. The outcomes in mind were to strengthen awareness about HIV, and knowledge about PrEP among at-risk youth.

Our Findings

In order to create an effective campaign, we had to first gain a better understanding of this demographic, and the issues they face. Through in-depth exploratory research, we learned about the current perceptions and attitudes about HIV and challenges towards getting medical services.

This demographic faces many hurdles, including stereotypes, discrimination, and safety concerns. Due to the stigma of an HIV/AIDS diagnosis, some participants said they live in “constant anxiety” and anticipation of judgment. Many worried that partners wouldn’t be honest with them about their status, or worried that they couldn’t be open about their own status.

This atmosphere has lead to mistrust and an absence of open communication. Furthermore, participants felt that healthcare professionals lack training on how to deliver health care services to the LGBTQ community. Participants expressed that this has resulted in feelings of isolation, shame, and fear.

There’s a lack of knowledge about PrEP beyond its basic uses and benefits as a preventative measure against HIV. This has led to confusion, misinformation, and distrust about PrEP’s side effects and efficacy. Trans Women of Color were especially worried about the side effects, as they thought PrEP might interfere with the efficacy of their hormones.


Through our research, we learned the campaign needed to be educational, inclusive, and set the right tone. Many black LGBT people feel overly targeted and further stigmatized by current HIV prevention campaigns. They want to see a diverse campaign that conveys that “anyone” can catch an STI, “not just them.” Participants needed the ads to be relatable and “real”, yet authoritative and trustworthy. They wanted to see a campaign that humanizes those living with HIV, destigmatizes the diagnosis, and promotes getting tested.

The invaluable feedback from our research showed the importance of informed strategies to prevent alienating the people you’re trying to reach, and to break down the barriers in the way of its success. We learned that the key to reaching this demographic is to make them feel included, not targeted. This helped reshape the campaign to increase the appeal and effectiveness so that they can see themselves reflected in it. The end result was a sensitive, relatable, positive campaign with wide-reaching effects.

Check out the final campaign:

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