Assessing the Feasibility of Hairdressers as Sexual Health Champions

Overview

Clinicians working within sexual health services feel there is a theme of later diagnoses of Human Immunodeficiency Virus (HIV) and the lack of uptake of HIV pre-exposure prophylaxis (PrEP) use among women, particularly black African women in the United Kingdom (UK). This is supported by evidence from the annual report on HIV in the East of England (1). In view of this investigators will explore the feasibility of hairdressers acting as sexual health champions in the region. This may include equipping hairdressers with knowledge about HIV prevention or just providing information about services available at local sexual health clinics to their clients. The project will also assess whether this would be acceptable to current clients, including those people living with HIV (PLWHIV).

Despite significant advances in HIV prevention and treatment, stigma, misinformation, and barriers to access continue to hinder progress-particularly among underserved and at-risk communities. Late diagnosis of HIV remains an important issue in the East of England. By ethnic group, black Africans were more likely to be diagnosed late than the white population and represented 48% of all newly diagnosed East of England residents in 20221. In terms of health inequalities in the Uk, PrEP need identification, prescribing and continuation among women remains relatively low (2,3). According to data from 2024 an average of 1% of all PrEP prescriptions done in the England were for cisgender woman4. This further highlight the huge disparity between PrEP need and use currently facing women. The recently published UK HIV action plan which aims to have no new HIV transmissions by 2030 in the UK has focused on five key populations which includes Black heterosexual women(5). It has also highlighted the need for improving regular testing among these key populations and using innovating ways to improve PrEP access for all who need it(5). The British HIV Association (BHIVA)/ British Association of Sexual Health and HIV(BASHH) PrEP guidelines 2025 also discuss improving access and equitability to ensure all people in need of PrEP have access to this.(5,6) This project aims to address some of the above by assessing feasibility of having hairdressers as sexual health champions by providing information on services provided by local sexual health clinics and possibly training them to discuss HIV testing and PrEP with their clients in a mostly homebased non-clinical setting. Many individuals may not routinely engage with formal healthcare services due to fear of judgment, lack of awareness, or cultural and socioeconomic factors. Hairdressers often serve as informal confidants and trusted members of their communities, engaging in open, personal conversations with clients in a safe space. This presents a unique and underutilized opportunity to deliver health promotion in a stigma-free environment. However, limited research exists on applying this approach to sexual health in resource rich settings (7,8). This project responds to that gap, exploring whether equipping hairdressers to serve as sexual health advocates can increase awareness, reduce stigma, and improve access to local services. It aims to test both the acceptability and practicality of this approach, laying the groundwork for a scalable community health intervention that reaches people where they are and empowers both professionals and clients to take charge of their sexual health with the help of our outreach community.