2025-12-02
HIV & young people: what if we changed the rules?
Infectiology
By Ana Espino | Published on December 2nd, 2025 | 2 min read
Human Immunodeficiency Virus (HIV) remains a major public health issue, especially in high-prevalence countries where it continues to cause substantial morbidity and mortality. Young people—particularly young women—represent an especially vulnerable population. They often struggle to access appropriate health services, and many avoid testing or care due to fear of judgment or barriers such as distance, cost, or poor treatment by staff. Added to this is the fact that current services are poorly adapted to their needs: they are too fragmented between HIV care and sexual health, insufficiently flexible, difficult to access, and rarely designed with young people in mind.
In response to these shortcomings, new approaches aim to offer integrated, simple, and free services that can facilitate testing, improve prevention, and support young people in accessing care when needed. It is in this context that the CHIEDZA study was conducted. It aimed to test a community-based, integrated model combining HIV and sexual and reproductive health (SRH) services tailored for young people aged 16 to 24, in order to assess its impact on access to and uptake of these services.
The study was based on a randomized trial carried out in three provinces, involving 12 clusters that received a mobile community intervention over 30 months. Youth-dedicated centers provided free, walk-in services including HIV testing, contraception, menstrual products, condoms, primary health care, and psychosocial support. In total, 36,991 young people aged 16–24 participated, generating 78,809 visits.
The program showed high acceptability, with 84% of young people agreeing to an HIV test. On average, each visit included access to three different services. Young women predominantly sought:
Young men mainly used:
Conversely, HIV self-testing was used very rarely, revealing a strong preference for provider-supervised testing. This choice reflects a clear need for reassuring human interaction in the context of HIV screening.
HIV care for young people remains a major challenge, both structurally and operationally. Without services that are truly integrated, accessible, and adapted to their lived realities, a large proportion of this population remains disconnected from testing, prevention, and treatment.
It is within this context that the CHIEDZA project was launched, aiming to provide a free, community-based, walk-in service centered on the real needs of young people. This mobile, non-stigmatizing approach demonstrated that it is possible to significantly improve access to HIV/SRH services by creating a supportive environment, strengthened by peer involvement and combined with practical, attractive offerings—such as menstrual products, analgesics, or contraception. The study therefore confirms that integrating HIV and sexual health services in a single youth-friendly space fosters engagement and retention.
However, several limitations remain, low male participation, lack of behavioral data, mental health support gaps, etc., highlighting the need for further research and broader implementation. Future steps should include adapting the CHIEDZA model for young men, integrating PrEP and PEP into the service package, strengthening mental health support, and embedding such programs within national public health policies to ensure continuous, equitable, and sustainable care for young people affected by HIV.
About the author – Ana Espino
As a scientific writer, Ana is passionate about bridging the gap between research and real-world impact. With expertise in immunology, virology, oncology, and clinical studies, she makes complex science clear and accessible. Her mission: to accelerate knowledge sharing and empower evidence-based decisions through impactful communication.
Human Immunodeficiency Virus (HIV) remains a major public health issue, especially in high-prevalence countries where it continues to cause substantial morbidity and mortality. Young people—particularly young women—represent an especially vulnerable population. They often struggle to access appropriate health services, and many avoid testing or care due to fear of judgment or barriers such as distance, cost, or poor treatment by staff. Added to this is the fact that current services are poorly adapted to their needs: they are too fragmented between HIV care and sexual health, insufficiently flexible, difficult to access, and rarely designed with young people in mind.
In response to these shortcomings, new approaches aim to offer integrated, simple, and free services that can facilitate testing, improve prevention, and support young people in accessing care when needed. It is in this context that the CHIEDZA study was conducted. It aimed to test a community-based, integrated model combining HIV and sexual and reproductive health (SRH) services tailored for young people aged 16 to 24, in order to assess its impact on access to and uptake of these services.
What really brings young people in?
The study was based on a randomized trial carried out in three provinces, involving 12 clusters that received a mobile community intervention over 30 months. Youth-dedicated centers provided free, walk-in services including HIV testing, contraception, menstrual products, condoms, primary health care, and psychosocial support. In total, 36,991 young people aged 16–24 participated, generating 78,809 visits.
The program showed high acceptability, with 84% of young people agreeing to an HIV test. On average, each visit included access to three different services. Young women predominantly sought:
- menstrual products (95.4%),
- analgesics (59.9%),
- contraceptives (35.9%).
Young men mainly used:
- condom distribution services (93.9%),
- HIV testing (85.6%),
- sexual health information SMS (67.1%).
Conversely, HIV self-testing was used very rarely, revealing a strong preference for provider-supervised testing. This choice reflects a clear need for reassuring human interaction in the context of HIV screening.
Care tailored to them — and a lasting impact?
HIV care for young people remains a major challenge, both structurally and operationally. Without services that are truly integrated, accessible, and adapted to their lived realities, a large proportion of this population remains disconnected from testing, prevention, and treatment.
It is within this context that the CHIEDZA project was launched, aiming to provide a free, community-based, walk-in service centered on the real needs of young people. This mobile, non-stigmatizing approach demonstrated that it is possible to significantly improve access to HIV/SRH services by creating a supportive environment, strengthened by peer involvement and combined with practical, attractive offerings—such as menstrual products, analgesics, or contraception. The study therefore confirms that integrating HIV and sexual health services in a single youth-friendly space fosters engagement and retention.
However, several limitations remain, low male participation, lack of behavioral data, mental health support gaps, etc., highlighting the need for further research and broader implementation. Future steps should include adapting the CHIEDZA model for young men, integrating PrEP and PEP into the service package, strengthening mental health support, and embedding such programs within national public health policies to ensure continuous, equitable, and sustainable care for young people affected by HIV.
Read next: HDL: an ally going off track?
About the author – Ana Espino
PhD in Immunology, specialized in Virology
Last press reviews
HIV & young people: what if we changed the rules?
By Ana Espino | Published on December 2nd, 2025 | 2 min read
Will biomarkers save patients with refractory testicular germ cell tumors?
By Lila Rouland | Published on December 1rst, 2025 | 3 min read<br>