Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
Shopping Cart: ( empty )
You are here: Home > Journals > SH > SH24233
RESEARCH ARTICLE (Open Access)
Contents Vol 22(3)

Strategies to sustain HIV prevention interventions among adolescents and young adults: analysis of data from a crowdsourcing open call in Nigeria

Ujunwa Onyeama https://orcid.org/0000-0002-0455-7100 A # * , Lauren Fidelak A # , Weiming Tang https://orcid.org/0000-0002-9026-707X A , Susan Nkengasong B , Titilola Gbaja-Biamila C D , Lateef Akeem C , Adesola Zaidat Musa C , Folahanmi Tomiwa Akinsolu C E , Tomilola Musari-Martins https://orcid.org/0000-0001-9961-1300 C , Jane Okwuzu C , Aishat Adedoyin Koledowo D , Suzanne Day F , Temitope Ojo F , Olufunto A. Olusanya F , Kadija M. Tahlil G , Donaldson F. Conserve H , Oluwaseun Adebayo Bamodu H , Nora E. Rosenberg I , Ucheoma Nwaozuru J , Chisom Obiezu-Umeh K , Collins Airhihenbuwa L , Oliver Ezechi C D , Juliet Iwelunmor F and Joseph D. Tucker https://orcid.org/0000-0003-2804-1181 A B *
+ Author Affiliations
- Author Affiliations

A Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

B Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, England.

C Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria.

D Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA.

E Department of Public Health, Faculty of Basic Medical and Health Sciences, Lead City University, Ibadan, Nigeria.

F Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

G Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

H Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.

I Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

J Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, NC, USA.

K Department of Medical Social Sciences, Center for Dissemination and Implementation Science, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

L School of Public Health, Georgia State University, Atlanta, GA, USA.

* Correspondence to: ujunwa_onyeama@med.unc.edu, jdtucker@med.unc.edu

# These authors contributed equally to this paper

Handling Editor: Megan Lim

Sexual Health 22, SH24233 https://doi.org/10.1071/SH24233
Submitted: 6 December 2024  Accepted: 27 March 2025  Published: 28 April 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY)

Abstract

Background

Crowdsourcing is a process whereby a large group, including experts and non-experts, collaborate to solve a problem and then share the solution with the public. Crowdsourcing can be used to identify strategies to sustain HIV services in low-and-middle-income countries. This study aims to identify innovative adolescent and young adult (AYA) solutions through a crowdsourcing open call to sustain HIV services.

Methods

Building on HIV prevention services developed by AYA from an initial open call, we organized a crowdsourcing open call to identify innovative, AYA-led strategies to sustain these services through partnerships with the community. The open call question was, ‘How might we sustain the 4 Youth by Youth HIV prevention services while nurturing our existing relationships, practices, procedures and services that will last in our communities?’. All submissions were assessed based on prespecified judging criteria. Qualitative data were analyzed using thematic analysis and categorized into strategies for sustaining AYA-friendly HIV prevention services in Nigeria.

Results

We received 102 eligible submissions from AYA. Twenty-three submissions met the mean score threshold and were qualitatively analyzed. Through this analysis, we identified four strategies for sustaining AYA-friendly HIV prevention services in Nigeria: AYA engagement and leadership in research, digital health solutions, financing and efficiency, and partnerships.

Conclusion

This open call highlights how strategies developed by AYA may sustain AYA-friendly HIV prevention services. Our findings offer key insights for maintaining HIV prevention services in Nigeria and other similar settings.

Keywords: 4YBY, adolescents, AYA, AYA-friendly strategies, crowdsourcing, HIV prevention, open call, sustainability, young adults.

References

1  Wong VJ, Murray KR, Phelps BR, Vermund SH, McCarraher DR. Adolescents, young people, and the 90–90–90 goals a call to improve HIV testing and linkage to treatment. AIDS 2017; 31: S191-S194.
| Crossref | Google Scholar |

2  Winskell K, Singleton R, Sabben G, et al. Social representations of the prevention of heterosexual transmission of HIV among young Africans from five countries, 1997–2014. PLoS ONE 2020; 15(3): e0227878.
| Crossref | Google Scholar |

3  Nyblade L, Mingkwan P, Stockton MA. Stigma reduction: an essential ingredient to ending AIDS by 2030. Lancet HIV 2021; 8(2): e106-e113.
| Crossref | Google Scholar |

4  Gausman J, Othman A, Al-Qotob R, et al. Measuring health service providers’ attitudes towards the provision of youth-friendly sexual and reproductive health services: a psychometric study to develop and validate a scale in Jordan. BMJ Open 2022; 12(2): e052118.
| Crossref | Google Scholar | PubMed |

5  World Health Organization. Making health services adolescent friendly: developing national quality standards for adolescent friendly health services. World Health Organization; 2012. Available at https://iris.who.int/handle/10665/75217 [accessed 11 February 2025]

6  Tahlil KM, Rachal L, Gbajabiamila T, et al. Assessing engagement of adolescents and young adults (AYA) in HIV research: a multi-method analysis of a crowdsourcing open call and typology of aya engagement in Sub-Saharan Africa. AIDS Behav 2023; 27(S1): 116-127.
| Crossref | Google Scholar |

7  Dunn Navarra A-M, Gormley M, Liang E, et al. Developing and testing a web-based platform for antiretroviral therapy (ART) adherence support among adolescents and young adults (AYA) living with HIV. PEC Innov 2024; 4: 100263.
| Crossref | Google Scholar | PubMed |

8  Vorkoper S, Tahlil KM, Sam-Agudu NA, et al. Implementation science for the prevention and treatment of HIV among adolescents and young adults in Sub-Saharan Africa: a scoping review. AIDS Behav 2023; 27(S1): 7-23.
| Crossref | Google Scholar |

9  Iwelunmor J, Blackstone S, Veira D, et al. Toward the sustainability of health interventions implemented in sub-Saharan Africa: a systematic review and conceptual framework. Implement Sci 2016; 11(1): 43.
| Crossref | Google Scholar |

10  Moore JE, Mascarenhas A, Bain J, Straus SE. Developing a comprehensive definition of sustainability. Implement Sci 2017; 12(1): 110.
| Crossref | Google Scholar | PubMed |

11  Hall A, Shoesmith A, Doherty E, et al. Evaluation of measures of sustainability and sustainability determinants for use in community, public health, and clinical settings: a systematic review. Implement Sci 2022; 17(1): 81.
| Crossref | Google Scholar | PubMed |

12  Shelton RC, Cooper BR, Stirman SW. The sustainability of evidence-based interventions and practices in public health and health care. Annu Rev Public Health 2018; 39(1): 55-76.
| Crossref | Google Scholar |

13  UNAIDS. Ending the AIDS epidemic for adolescents, with adolescents. 2016. Available at https://www.unaids.org/en/resources/documents/2016/ending-AIDS-epidemic-adolescents

14  Herlitz L, MacIntyre H, Osborn T, Bonell C. The sustainability of public health interventions in schools: a systematic review. Implement Sci 2020; 15(1): 4.
| Crossref | Google Scholar | PubMed |

15  Schell SF, Luke DA, Schooley MW, et al. Public health program capacity for sustainability: a new framework. Implement Sci 2013; 8(1): 15.
| Crossref | Google Scholar |

16  Pettifor A, Bekker L-G, Hosek S, et al. Preventing HIV among young people: research priorities for the future. J Acquir Immune Defic Syndr 2013; 63(Supplement 2): S155-S160.
| Crossref | Google Scholar |

17  Day S, Tahlil KM, Shah SJ, et al. The HIV open call on informed consent and ethics in research (VOICE) for adolescents and young adults: a digital crowdsourcing open call in low- and middle-income countries. Sex Transm Dis 2024; 51(5): 359-366.
| Crossref | Google Scholar | PubMed |

18  Jointed United Nations Programme on HIV/AIDS (UNAIDS). HIV response sustainability primer. UNAIDS; 2024. Available at https://www.unaids.org/en/resources/documents/2024/20240117_HIV_response_sustainability

19  U.S. Department of State. 2019 Sustainability index and dashboard summary: Nigeria. 2019. Available at https://www.state.gov/wp-content/uploads/2019/12/Nigeria-SID-2019.pdf

20  National Agency for the Control of AIDS (NACA). National HIV strategy for adolescents and young people 2016–2020. National Agency for the Control of AIDS, NACA; 2016. Available at https://naca.gov.ng/wp-content/uploads/2017/07/National-HIV-Strategy-For-Adolescents-and-Young-People.pdf

21  Han L, Chen A, Wei S, Ong JJ, Iwelunmor J, Tucker JD. Crowdsourcing in health and health research: a practical guide. World Health Organization (WHO); 2018. Available at https://apo.who.int/publications/i/item/2018-07-11-crowdsourcing-in-health-and-health-research-a-practical-guide [accessed 17 July 2024]

22  Iwelunmor J, Tucker JD, Obiezu-Umeh C, et al. The 4 Youth by Youth (4YBY) pragmatic trial to enhance HIV self-testing uptake and sustainability: study protocol in Nigeria. Contemp Clin Trials 2022; 114: 106628.
| Crossref | Google Scholar | PubMed |

23  Iwelunmor J, Ezechi O, Obiezu-Umeh C, et al. Enhancing HIV self-testing among Nigerian youth: feasibility and preliminary efficacy of the 4 Youth by Youth Study using crowdsourced youth-led strategies. AIDS Patient Care STDs 2022; 36(2): 64-72.
| Crossref | Google Scholar | PubMed |

24  Rosenberg NE, Obiezu-Umeh C, Gbaja-Biamila T, et al. Strategies for enhancing uptake of HIV self-testing among Nigerian youths: a descriptive analysis of the 4YouthByYouth crowdsourcing contest. BMJ Innov 2021; 7(3): 590-596.
| Crossref | Google Scholar | PubMed |

25  Hildebrand M, Ahumada C, Watson S. CrowdOutAIDS: crowdsourcing youth perspectives for action. Reprod Health Matters 2013; 21(41): 57-68.
| Crossref | Google Scholar | PubMed |

26  Scheirer MA, Dearing JW. An agenda for research on the sustainability of public health programs. Am J Public Health 2011; 101(11): 2059-2067.
| Crossref | Google Scholar | PubMed |

27  Corbin J, Strauss A. Basics of qualitative research (3rd Ed.): techniques and procedures for developing grounded theory. SAGE Publications, Inc.; 2008. 10.4135/9781452230153

28  Naeem M, Ozuem W, Howell K, Ranfagni S. A step-by-step process of thematic analysis to develop a conceptual model in qualitative research. Int J Qual Methods 2023; 22: 16094069231205789.
| Crossref | Google Scholar |

29  Chambers DA, Glasgow RE, Stange KC. The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implement Sci 2013; 8(1): 117.
| Crossref | Google Scholar |

30  Iwelunmor J, Ezechi O, Obiezu-Umeh C, et al. The 4 youth by youth HIV self-testing crowdsourcing contest: a qualitative evaluation. PLoS ONE 2020; 15(5): e0233698.
| Crossref | Google Scholar |

31  Tang W, Han L, Best J, et al. Crowdsourcing HIV test promotion videos: a noninferiority randomized controlled trial in China. Clin Infect Dis 2016; 62(11): 1436-1442.
| Crossref | Google Scholar | PubMed |

32  Abrams EA, Burke VM, Merrill KG, et al. “Adolescents do not only require ARVs and adherence counseling”: a qualitative investigation of health care provider experiences with an HIV youth peer mentoring program in Ndola, Zambia. PLoS ONE 2021; 16(6): e0252349.
| Crossref | Google Scholar |

33  Iwelunmor J, Ezechi O, Obiezu-Umeh C, et al. Tracking adaptation strategies of an HIV prevention intervention among youth in Nigeria: a theoretically informed case study analysis of the 4 Youth by Youth Project. Implement Sci Commun 2023; 4(1): 44.
| Crossref | Google Scholar | PubMed |

34  Reed SJ, Miller RL, The Adolescent Medicine Trials Network for HIV/AIDS Interventions. The benefits of youth engagement in HIV-preventive structural change interventions. Youth Soc 2014; 46(4): 529-547.
| Crossref | Google Scholar | PubMed |

35  Zakumumpa H, Bennett S, Ssengooba F. Leveraging the lessons learned from financing HIV programs to advance the universal health coverage (UHC) agenda in the East African Community. Glob Health Res Policy 2019; 4(1): 27.
| Crossref | Google Scholar |

36  Itiola AJ, Agu KA. Country ownership and sustainability of Nigeria’s HIV/AIDS supply chain system: qualitative perceptions of progress, challenges and prospects. J Pharm Policy Pract 2018; 11(1): 21.
| Crossref | Google Scholar |

37  Ogbuabor D, Olwande C, Semini I, Onwujekwe O, Olaifa Y, Ukanwa C. Stakeholders’ perspectives on the financial sustainability of the HIV response in Nigeria: a qualitative study. Glob Health Sci Pract 2023; 11(2): e2200430.
| Crossref | Google Scholar | PubMed |

38  Remme M, Siapka M, Sterck O, Ncube M, Watts C, Vassall A. Financing the HIV response in sub-Saharan Africa from domestic sources: Moving beyond a normative approach. Soc Sci Med 2016; 169: 66-76.
| Crossref | Google Scholar | PubMed |

39  Nwizu J, Ihekanandu U, Ilika F. Increasing domestic financing for the HIV/AIDS response in Nigeria: a catalyst to self-reliance. Lancet Glob Health 2022; 10: S25.
| Crossref | Google Scholar |

40  World Health Organization (WHO). Adolescent-friendly health services for adolescents living with HIV: from theory to practice. World Health Organization (WHO); 2019. Available at https://www.who.int/publications/i/item/adolescent-friendly-health-services-for-adolescents-living-with-hiv

41  Musuka G, Moyo E, Cuadros D, Herrera H, Dzinamarira T. Redefining HIV care: a path toward sustainability post-UNAIDS 95-95-95 targets. Front Public Health 2023; 11: 1273720.
| Crossref | Google Scholar | PubMed |

42  Bulstra CA, Hontelez JAC, Otto M, et al. Integrating HIV services and other health services: a systematic review and meta-analysis. PLoS Med 2021; 18(11): e1003836.
| Crossref | Google Scholar |