Development of an acceptance based PrEP intervention (ACTPrEP) to engage young black MSM in the South utilizing the Adaptome Model of intervention adaptation

•HIV disproportionately affects young Black men who have sex with men (YBMSM). Pre-exposure prophylaxis (PrEP) prevents HIV.•20 PrEP-eligible YBMSM and 10 clinic staff in Mississippi were surveyed and interviewed between October 2021 and April 2022.•Thematic categories: thoughts, emotions, associations, memories, and sensations, health behaviors, values, and adaptations.•Interventions informed by ACT can help YBMSM endure short-term discomfort and increase willingness to initiate PrEP.