Project Summary Adolescents and young adults 15-29 years are twice as likely to be infected with HIV and twice as likely to be infected with a sexually transmitted infection (STI) as the average Alabama resident. These statistics emphasize the urgency for sexual and reproductive health services (SRHS) interventions with Black adolescent and young adult females in Alabama, especially those historically underserved who live in impoverished and rural, isolated areas. The goal of the study is to use participatory and empowerment approaches to achieving health equity in HIV prevention for young rural Black females in Alabama. Our study objective is to assess the SRHS experiences (including HIV testing, pre-exposure prophylaxis access) of rural Black females in Alabama and to initiate intervention planning with the Ending the HIV Epidemic-Alabama (EHA) Advisory Committee to reduce new HIV infections among young Black females. In Aim 1, we will examine rural Black females’ SRHS lived experiences across generations using a participatory qualitative method, Photovoice. We will recruit 30 rural Black mothers and their adolescent daughters (aged 13-17) and 40 rural Black young adult females (aged 18-29). Photovoice includes study participants taking photos and describing how the photo reflects personal and community strengths and challenges--the photos will capture the strengths and challenges of SRHS in rural Alabama. They will also complete an online survey to broadly assess SRHS (including HIV testing, PrEP access). In Aim 2, we aim to identify problems and develop a plan (i.e., intervention) to resolve the problem of persistent HIV disparities among young rural Black females using the Soft Systems Methodology (SSM) approach with the EHA committee. SSM is a participatory method that involves multiple systems (e.g., EHA, individuals, institutions) to identify the root causes of the problem and collectively generate an action plan (intervention) for resolution. This will be a 5-day workshop in which we will incorporate the SSM 7-step process. This participatory process will include the EHA determining the level of intervention (individual, institutional, policy, etc.) and meeting routinely with the principal investigator in Year 2 for design and implementation planning. The results will be used to develop an evaluative implementation science proposal for the EHA’s implemented plan of action (intervention). This proposed study is in response to PA-20-272: Administrative Supplements to Existing NIH Grants and Cooperative Agreements (Parent Admin Supp Clinical Trial Optional), specifically for supporting the Ending the HIV Epidemic (EHE) in the United States Initiative.