Explore how a youth-led HIV prevention programme in Nigeria achieved 73% sustained engagement over 24 months, especially among disadvantaged youth.
Adolescent and young adult (AYA; 14-24 years old) engagement in HIV programs is often transient, and socioeconomically marginalized AYA are less engaged. Few studies have examined whether engagement can be sustained over time in HIV prevention programs. This study examines correlates of sustained AYA engagement over 24 months in an HIV prevention program in Nigeria.
We conducted a secondary data analysis of longitudinal data from an HIV prevention program among AYA in 32 local communities in Nigeria from 2021 to 2023. Participants were invited to join crowdsourcing open calls, peer-led support meetings, and other activities. Engagement was assessed using a modified 12-item Tiffany-Eckenrode Program Participation Scale (0-4 per item) at months 3, 6, 12, 18, and 24. Sustained AYA engagement was defined as a mean score ≥3.0/4.0 in at least three consecutive contacts (approximately 12 months). Longitudinal analysis was conducted using generalized estimating equations, and state-level contextual analysis was done using a linear mixed model.
The result showed a total of 1,259 AYA were included. The mean age was 19.8 ± 2.7 years; most were students (n=954,75.8%) and unemployed (n=810,64.3%). The mean participation score remained consistently high throughout the 24 months (3.245 ±0.535 to 3.319 ±0.556), with 73.0% demonstrating sustained engagement. Students were less likely to sustain engagement compared to non-students (aRR = 0.91; 95% CI: 0.84-0.97). Unemployed AYA were more likely to sustain engagement than employed AYA (aRR= 1.09; 95% CI:1.03-1.14). States with higher poverty had significantly greater sustained AYA engagement. All the main findings were robust in sensitivity analyses.
It is concluded that AYA engagement in the HIV self-testing implementation was high and sustained over 24 months, especially among socio-economically disadvantaged populations. This study supports a participatory, AYA-led approach to sustaining AYA engagement in HIV prevention programs and has implications for HIV program equity.
Speaker
Abdulhammed Babatunde
Abdulhammed Babatunde is a medical doctor, digital health innovator, and global health researcher from Nigeria. He is passionate about expanding access to healthcare for underserved communities. His research uses participatory approaches such as crowdsourcing and co-creation to develop community-based and digital health solutions for HIV prevention and maternal health in low-resource settings. He has published in international peer-reviewed journals, including Nature, BMJ, and BMC. He is an International Health Systems Innovation Leaders Scholar pursuing an MSc in Health Systems, Policy and Innovation at the UCL Global Business School for Health.
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