Youth Deserve Better—How We’re Changing HIV Testing Norms in Zambia

Youth Deserve Better—How We’re Changing HIV Testing Norms in Zambia

Guest Authors: Precious Kaniki and Joshua Kasuba | Project YouthLink, Zambia

This blog post is the third in a series written by teams participating in the 2025 INSPIRE Designathon. Chosen from hundreds of submissions, these teams participated in a dynamic three-day sprint to sharpen their ideas and pitch innovative solutions to a panel of expert judges. Each team received funding to implement, adapt, and scale-up HIV interventions for adolescents and young adults over the coming year.

Headshots of the four members of Project YouthLinkProject YouthLink was born from a simple yet powerful question:

What if young people could access HIV testing on their own terms, in their own spaces, with their peers by their side?

As researchers and advocates in Zambia, we have witnessed too many young people arriving at health facilities only after being sick for months—sometimes even years—without ever having taken an HIV test. Many delayed testing out of fear of stigma, because clinics felt unwelcoming, or because the nearest facility was too far away. It was heartbreaking to see young people suffer needlessly from a manageable health condition they didn’t know they had.

We knew something had to change. We wanted to re-imagine what HIV testing could look like for young people in Zambia—accessible, stigma-free, and centered on their realities.

Our Approach: Bringing HIV Testing Closer to Youth

Project YouthLink is a youth-led, community-centered initiative designed to bring HIV testing closer to young people through mobile outreach, peer navigation, and digital tools.

  • Mobile diagnostic outreach brings testing to markets, schools, and even remote places 
  • Peer navigation ensures every young person who tests knows they are not alone—whether their result is positive or negative
  • Digital linkage tools help track referrals, send reminders, and support follow-ups discreetly and effectively

In essence, YouthLink is a bridge—between community and clinic, between fear and support, between silence and action.

From Idea to Impact

When we first shared this idea at the INSPIRE Designathon, we had the passion but not the perfect words. We were advocates and not presenters. But through mentorship and participatory learning sessions, we refined our design, learned to communicate our vision more clearly, and grew confident in presenting our work to the community

One of our biggest realizations was that diagnostics aren’t just medical—they’re social.

A test is not just a result. It’s a moment of truth that can either isolate or empower. It’s a doorway to dignity, care, and hope.

Youth are not just the future of the HIV response—they are the present. And when we truly listen to them, solutions stop being about them and start being with them. This demands trust, privacy, and peer support — all central to what our project offers.

What We've Accomplished

So far, we have trained peer educators and navigators and carried out a pilot outreach. It hasn’t been entirely smooth—particularly in peri-urban communities. Some challenges we’ve faced include persistent stigma and limited knowledge about HIV testing among youth. One young girl told us that she was afraid of testing because most of the health workers are older people who judge young people. That perspective reaffirms exactly why this project matters: testing services must be brought to young people in spaces where they feel safe and understood.

Looking Ahead

We envision a Zambia where no young person discovers their HIV status too late — where diagnosis is early, stigma is reduced, and linkage to care is seamless.

Our next steps include scaling project YouthLink to more districts, strengthening partnerships with stakeholders, and integrating our model within the national HIV response.

We believe young people are not just beneficiaries — they are drivers of change. And with Project YouthLink, we are proving that when youth lead, the future of health equity shines brighter for all.

Breaking the Silence: Youth-Led Fight Against HIV Stigma in Northern Nigeria

Breaking the Silence: Youth-Led Fight Against HIV Stigma in Northern Nigeria

Guest Authors: Favour Christiana Ogbuagu, Abubakar Ismail Zango, Makkiyyah Sulaiman Muhammad, and Abdulmalik Ya’u | Youth Against HIV, Nigeria.

This blog post is the second in a series written by teams participating in the 2025 INSPIRE Designathon. Chosen from hundreds of submissions, these teams participated in a dynamic three-day sprint to sharpen their ideas and pitch innovative solutions to a panel of expert judges. Each team received funding to implement, adapt, and scale-up HIV interventions for adolescents and young adults over the coming year.

 In Northern Nigeria, conversations about HIV among adolescents are often silenced by stigma and shame. Studies show that more than nine out of ten young people in Nigeria hold stigmatizing attitudes toward people living with HIV, a reality that discourages testing, treatment, and open discussion.

This stigma weighs even more heavily on adolescent girls, who face layers of judgment tied to gender norms and patriarchal expectations. Many young people internalize these negative messages, hiding their fears, questions, or even their HIV status. Myths persist from the belief that HIV only affects “immoral” people to the idea that it can be cured with traditional medicine. In addition, reliable HIV information is not always available in Hausa, the most widely spoken language in Northern Nigeria. This gap leaves many adolescents uninformed or misinformed.

Our team— Youth Against HIV (YAGH) — saw these challenges firsthand and knew we needed to respond differently. Through the INSPIRE Designathon, we designed a project to:

  • Train peer champions to lead conversations on HIV
  • Strengthen digital tools to include Hausa-language support
  • Establish school-based HIV awareness clubs that can sustain these conversations over time

Why Youth-Led Approaches Matter

Young people often tune out when adults lecture them about HIV. But when the same message comes from a peer – someone who shares their language, humor, and lived experience, it resonates differently.

That is why we placed young people at the center of this intervention. We are training medical students to serve as HIV peer champions not as lecturers, but as conversation starters. Their mission is to create safe spaces where secondary school students feel comfortable asking questions they might otherwise keep hidden.

The Role of Digital Innovation

Language emerged as a key barrier. Much of the available HIV content is in English, leaving many Hausa-speaking adolescents excluded.

To address this, we are strengthening the Youth Leading HIV Awareness Campaign (YOLHAC) digital platform owned by Bridge Connect Africa Initiative by enabling its AI-powered chatbot to function in Hausa during the project period. This allows adolescents to ask questions anonymously, in Hausa or English, and receive accurate, evidence-based answers.

The classroom sessions will open the door to conversation, while the chatbot ensures those conversations can continue privately, at each student’s own pace. For many, that privacy is what makes it possible to ask sensitive questions without fear.

Implementation in Kano: Our Journey

Our journey to this point has been anything but linear. We initially planned to launch in Katsina State, but prolonged ethical clearance processes stalled the timeline. To keep momentum, we pivoted to Kano, which shares Katsina’s cultural and linguistic context.

In September 2025, we successfully trained a dedicated group of YAGH Champions, ten medical students passionate about changing the HIV narrative among their peers. Over two days, they gained skills in:

  • HIV education and stigma reduction
  • Communication and facilitation
  • Digital literacy
  • Professional conduct and community engagement

The sessions were interactive and practical, equipping the champions to confidently reach secondary school students and lead meaningful discussions. This training marked a key milestone: the transition from planning to action.

Lessons Learned So Far

Even before school implementation begins, the training phase has provided valuable insights:

  • Young people are eager to lead. The energy and commitment of our champions confirmed that youth want to be part of the solution, not just passive recipients.
  • Training builds confidence. Many champions had never facilitated HIV discussions before, but left the training prepared and motivated to step into schools with clarity and purpose.
  • Digital tools need visibility. The YOLHAC webpage and chatbot are powerful resources, but they must be actively promoted so students trust and use them.
  • Partnerships are key. Support from schools, teachers, and community leaders will be crucial to gaining access and sustaining the awareness clubs we aim to establish.

 

Looking Ahead

With the champions trained, the next step is implementation. Over the coming weeks, YAGH champions will visit five selected secondary schools in Kano to lead peer-to-peer HIV awareness sessions. These sessions will not end in the classroom. Students will be introduced to the YOLHAC platform, allowing them to continue learning privately, in their own language, and at their own pace.

We are also committed to establishing HIV Awareness Clubs in these schools. These clubs will serve as safe spaces where students can keep the conversation alive, supported by peer champions and teachers. Robust monitoring and reporting systems are in place to track progress, capture stories, and guide future scale-up to other states in Northern Nigeria.

Our journey so far has been about building a strong foundation, understanding the barriers, designing solutions, and equipping young people to lead the charge.

Training the YAGH champions is just the beginning. As they enter classrooms, they carry more than information; they carry hope, representation, and a promise: that HIV awareness can be youth-led, stigma-free, and accessible to every adolescent, in every language. Combining peer leadership with digital tools is more than an intervention; it is a pathway to breaking the silence and reshaping the narrative around HIV for young people across Northern Nigeria.

And this is only the beginning.

How we turned our safe space into a digital lifeline

How we turned our safe space into a digital lifeline

Guest Authors: Aness Simon and Tamanda Chingoli, Team HushBuddy, Malawi

This blog post is the first in a series written by teams participating in the 2025 INSPIRE Designathon. Chosen from hundreds of submissions, these teams participated in a dynamic three-day sprint to sharpen their ideas and pitch innovative solutions to a panel of expert judges. Each team received funding to implement, adapt, and scale-up HIV interventions for adolescents and young adults over the coming year.

Hush Buddy is a team of four from Malawi. When we first started working with adolescents and young adults (AYA) living with HIV, we saw the difference a safe space could bring. Through the Comfort Corner—a youth-friendly drop-in centre—we offered support groups, mental health counselling, vocational training and antiretroviral therapy (ART) adherence support. However, we noticed that our target population was not patronizing the Comfort Corner as much as we had hoped. Some were afraid of being seen at the clinic and having their status exposed. Others could not afford to spare time or the cost of travel for in-person sessions. As much as they wanted help, fear and circumstances kept them away.

The birth of Hush Buddy

We wanted to take everything good about Comfort Corner and make it accessible on any phone, whether smart or not. We answered the questions, “What if support didn’t require physically showing up?” and “What if help could meet young people exactly where they are, safely, quietly and privately?”

Hush Buddy is our answer. Hush Buddy is a mobile app based on Unstructured Supplementary Service Data (USSD), meaning it works on any phone and without needing internet or data—something the average Malawian does not have access to. With a few keypad presses, AYA can access mental health check-ins, connect with an accountability buddy, get medication reminders, or find a vocational training referral. Anonymously.

One challenge has been translating the warmth of in-person sessions and the sense of community that the Comfort Corner brings into a digital format. Some users weren’t sure how to use the USSD system or didn’t trust that help could really come from their phones. Others started using it but dropped off after a few tries. We had to simplify the language and make it feel like someone was on the other side. That human touch, even on a keypad, matters. We are learning that privacy is just as powerful as presence. When someone feels safe enough to reach out, that’s when real change starts.

Participating in the INSPIRE Designathon

Coming into the INSPIRE Designathon, we knew what we wanted to do, but we didn’t know how to explain it in a way that made sense beyond our circles. As nurses and program leads, we were used to thinking in care plans, community outreach, and session scheduling, not frameworks and logic models.

At first, we were nervous. The room was full of academics, researchers, and people using language that felt so far from our everyday work. But we listened. Slowly, things started to click. Through the mentorship sessions, we learned how to present our idea clearly and build a real pitch deck. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework helped us look at Hush Buddy from all angles.

We also learned how to collect meaningful qualitative data using focus group discussions, and how that data could be used to improve the service, not just for monitoring. Before the Designathon, we saw feedback as something you did at the end. Now, we see it as something that shapes the process from the start.

The participatory learning meetings continue to give us more than technical knowledge. The Designathon has given us a community. Hearing from other teams reminded us that everyone is learning as they go. We saw people trying, failing, reworking and that made space for us to show up honestly, too. It’s easy to feel like you’re behind when you’re still figuring things out, but through these meetings, we realized that showing up with questions is part of what makes this work real.

Piloting the Hush Buddy app

One of our biggest lessons came after we launched the pilot. We realized we had made assumptions. We thought a USSD platform would be easy for anyone to use. It wasn’t. Some users were confused by the menu. Others didn’t know whether pressing “1” would lead to real help or just a message. And a few didn’t return after trying it once.

We didn’t take that lightly. We held a feedback session with some of our youth participants and asked what would make it easier. The responses were honest: “Make it shorter,” “Say it in Chichewa,” “Tell us what to expect first.” We used that feedback to simplify the menu, adjust the tone of our messages, and rework our scripts to explain the steps more clearly. This process reminded us that youth are not just users; they are co-creators.

We want to see Hush Buddy reach youth in rural districts where HIV support is even harder to access and stigma is higher. We’re exploring partnerships with mobile networks like Airtel and TNM so that the USSD code can be zero-rated and truly free to use. Long-term, we hope the Ministry of Health and other national partners will adopt it into Malawi’s broader HIV support system, especially as a digital bridge for AYA transitioning out of Teen Clubs.

The process of building Hush Buddy has helped us grow as a team—from struggling to turn our idea into a pitch, to confidently presenting it to reviewers, to rewriting menus based on real user voices. We have been stretched in the best way. Innovation isn’t always tech-heavy. Sometimes, it’s about quietly creating something that meets people exactly where they are.

For us, Hush Buddy is not just a mobile tool. It’s a promise that support doesn’t have to be loud or public to be powerful. It can be quiet. It can be private. And it can still save lives.