Youth Guide Discussions on Improving HIV Services

Youth leaders share their takeaway messages to close JSI’s satellite, Fostering adolescent and youth health resilience: Engaging diverse populations in HIV programming, at ICASA 2023 in Zimbabwe. (Youth left to right: Philasande Dube, Samantha Siziba, Melissa Chiduke, Debrain Mugarapanyama). Photo by Sarah Denison-Johnston / JSI

Meaningful youth engagement has emerged as a cornerstone of effective HIV programs, especially in settings where HIV disproportionately impacts young people.

“In HIV, the challenge of improving health outcomes for youth is not merely biomedical; it’s the social and behavioral contexts that enable or bar people from living their healthiest lives,” explains Patience Ndlovu, vice president, Bantwana Initiative of World Education, a division of JSI. “To truly understand these contexts, we do not need virologists. The experts we need are the youth themselves, in all their diversity of lived experience.”

Convening Youth as Priority Stakeholders in Nigeria

Attendees of the first national symposium on HIV prevention models for adolescents and young people in Abuja, Nigeria in November 2023.

Nigeria has the highest prevalence of HIV among adolescents ages 15–19 in West and Central Africa. While there have been many successful efforts to curb HIV transmissions among this age group, they have not been well documented or widely disseminated. “As a population with high risk of HIV infection and low health-seeking behaviors, prevention is paramount,” says Haruna Aaron Sunday, the executive director of the African Network of Adolescents and Young People’s Development.

To fill this gap, JSI collaborated with the National Agency for the Control of AIDS (NACA) to hold the first national symposium on HIV prevention models for adolescents and young people in November 2023 in Abuja.* Attendees included adolescents and young people, public health experts, implementing partners, and decision makers in the federal government.

“A symposium like this, with participation from adolescents and young people, ensures their voice is heard on what they want,” says James Anenih, director of community prevention, care and support services, NACA. “It is not about implementers designing strategies; we work with the adolescents and young people to design the strategies that best suit them.”

Symposium discussions highlighted youth-led approaches to program design, as well as the role of tertiary and religious institutions in preventing HIV transmission and advanced disease. JSI’s long-standing collaboration with youth in program design has guided our own tertiary and religious institution HIV prevention model, which was successful in lowering transmission rates. NACA collaborates with JSI to implement this model and presented it at the 22nd International Conference on AIDS and STIs in Africa (ICASA).

JSI’s approach to technical support ensures that interventions funded by donor agencies are designed in a way that benefits and prioritizes Nigerians,” says Olawale Durosinmi-Etti, country lead for JSI Nigeria.

Youth Voices in the Spotlight

At the forefront of JSI’s satellite session at ICASA 2023, Fostering adolescent and youth health resilience: Engaging diverse populations in HIV programming, Zimbabwean youth led the way.

Their energetic discussion in a room with more than 150 engaged listeners highlighted critical areas including feedback from Philasande Dube, a DREAMS ambassador, on how meaningful youth engagement benefits program outcomes. Samantha Siziba, an HIV program facilitator, added that there are some barriers to stronger partnerships, warning that health care providers too often assume the role of parent rather than health care provider, leaving youth feeling scolded and fearful of the clinic.

At the same time, Melissa Chiduke, a community adolescent treatment supporter for Zvandiri, recommended that facilities and programs refrain from judgment and use approachable language to establish mutual respect and trust required for meaningful engagement and co-creation.

Debrain Mugarapanyama, co-chair of UNICEF Zimbabwe’s Adolescent and Youth Advisory Committee, called on governments to maintain youth representation in every ministry, and to honor the Abuja declaration by investing 15% of the national budget in the health sector, which could reduce commodity shortages and strengthen youth programs.

Their allies listened and reflected on their guidance.

It is essential that young people are engaged in accessible and thoughtful ways, not just in the implementation of services, but in the design,” Tijuana A James, USAID senior youth advisor for prevention and HIV clinical services, said. “They are the experts in their lives and their own care.”

After the satellite, conference participants shared their feedback on what they thought were the most important elements for accountability for youth meaningful engagement. Of the 58 people who responded, 43 emphasized the most basic principle of the inclusion of youth in all their diversity. Thirty-five responses also called for training, awareness, education, and sensitization for young leaders, the health care workers who support them, and broader community members.

“Let us not leave meaningful youth engagement as an afterthought!”

These final words of JSI’s satellite, spoken by Debrain, ring loud and clear. JSI is proud to host events that center youth voices, and holds itself accountable to meaningfully engaging youth throughout the design, implementation, and evaluation of our programs.

*The national symposium in Nigeria was implemented as part of JSI’s Nigeria Total Market Approach (TMA) to Condom and Lubricants Programming Project funded by the Heartland Alliance International.