Demand for oral PrEP has been an issue. How can we do marketing differently with a multi-product PrEP portfolio?

Casey Bishopp, FHI 360
Elmari Briedenhann, Wits RHI
Emily Donaldson, FHI 360

What do we want young women’s hearts to feel—and minds to think—about PrEP?

This question about the positioning of PrEP is central to its branding as a multi-product category. Branding is a strategy that can be used to affect behavior change by creating specific associations with and beliefs about certain products, services, health behaviors, or categories.

Positioning is a marketing strategy that determines the tone, look, and feel of marketing and communications materials. It provides a roadmap to what we say and how we say it. Positioning also enables marketing and communications to create an affinity with the target audience. It is our first step and north star for all subsequent marketing efforts.

By developing a PrEP category positioning strategy, the MOSAIC project aims to create one unified brand that is evidence-informed and connects with end users on an emotional level, informs high-quality campaigns and messaging that truly resonate with end users, and incorporates the concept of informed choice.

This positioning strategy is intended for the implementers who will develop national communication strategies and demand generation campaigns for PrEP. It will offer evidence-based guidance to inform creative briefs, which in turn guide creative concept development and campaign execution.

Developing a PrEP category positioning strategy has proved a unique process. We have no competitor products, but a multitude of issues to address, such as non-use and misinformation, to name a few. We also know that marketing for public health can and must consider contextual factors outside of a traditional positioning framework, such as service delivery structures and social determinants of health. We hope these six key lessons from our experience will help others as they navigate the branding and positioning process within public health care settings:

  1. Market with HIV prevention in mind, not just a single product. We know awareness of PrEP is still low. Rather than marketing each PrEP product individually, we should work to make PrEP in general more popular by framing it as a category of products comprised of various options. We heard from ministries of health that communication and marketing encouraging PrEP use as one part of combination prevention are more acceptable than those focusing on one product or service.
  2. Ministry of health input is critical to developing context-specific marketing. MOSAIC country partners emphasized the importance of enabling early and strategic engagement with key stakeholders to ensure alignment with country priorities and contexts. Positioning will not be useful or sustainable without buy-in from the institutions responsible for communicating and providing guidance about public health matters. Ministry officials know which messages and directions will work well within their contexts and if/how a particular message will mesh with existing efforts and will therefore be applied.
  3. Include the voices and perspectives of the target audience throughout the process. Engaging adolescent girls and young women as advisors to our positioning process allowed for powerful themes to emerge. While end-user perspectives are typically represented after the development of positioning or a creative brief, we engaged our NextGen Squad for regular feedback and input to ensure the positioning was resonant, relevant, and adaptable to a rapidly changing youth culture.
  4. Build on previous PrEP campaigns, research, and marketing work with adolescent girls and young women as the audience. Always start with existing evidence. We leveraged lessons from previous research and campaigns, relying on insights from a range of projects to start our positioning development process.
  5. Not everything we know—or learn—about our audience and their context should be translated into marketing. For example, we know HIV and PrEP are stigmatized, and many young women live in communities where that stigma is a barrier to access. But if we focus on stigma, we run the risk of reinforcing existing harmful norms. Instead, we should determine which insights are most likely to encourage and inspire positive action. It is particularly important that insights related to marketing for young women be examined through a gender-transformative lens to ensure that the ones we use support equality and do not reinforce gender inequalities or stereotypes.
  6. Iterate, iterate, iterate as market introduction gets closer. At MOSAIC, our positioning process has been a journey. We started with an early positioning strategy in 2022, and we continue to gather feedback and refine as we get closer to having a choice of PrEP products in the market.

What next?

In the project’s first year, our positioning work was driven by Mann Global Health with input and support from all other MOSAIC consortium country partners—Wits Reproductive Health Institute, Pangaea Zimbabwe AIDS Trust, LVCT Health, Jhpiego, and FHI 360. This work provided a foundation for the next iteration of positioning, for which we have engaged 2Stories, a content marketing firm based in South Africa. We’re excited to start validating our positioning direction with target audiences to make sure it resonates and is relevant across contexts so that we can bring the positioning to life by applying it to demand generation materials and campaigns. Stay tuned for more of what we learn and for our final positioning strategy this year!

For more information about our positioning strategy work, contact Emily Donaldson ( and Casey Bishopp (

Featured Graphic: Bridger Trap, FHI 360