Breaking Language Barriers: A Bilingual Approach to HIV Information

by Emily Hickner | Aug 17, 2026 | INSPIRE Designathon, Learning Core

In Spring 2025, the Youth Against HIV was one of ten teams selected out of hundreds to bring their vision to life through the INSPIRE Designathon. We appreciated their thoughtful approach to tackling widespread misconceptions about HIV and limited access to prevention, testing and treatment services in Nigeria’s Katsina State. They recognized three major obstacles — cultural norms, language barriers and stigma — and had an insightful approach to addressing them through peer education, culturally relevant materials, and community partnerships. This approach includes the development of educational materials in both English and Hausa, the primary language of Katsina State.

The result of the team’s hard work over the past year is the HIV Handbook for Everyone: Understanding, Preventing, and Living with HIV, a colorful and eye-catching handbook written in clear, simple language and available in both English and Hausa. It is an uncomplicated guide to what young people need to know: what HIV is, how to protect themselves, where to get tested, and how those living with HIV can thrive.

We asked Youth Against HIV about their process, how they plan to distribute the handbooks, and what’s next for the publication. Read on to learn what they had to say.

Youth Against HIV consists of Favour Christiana Ogbuagu, Abubakar Ismail Muhammad, Makiyyah Sulaiman Muhammad, and Abdulmalik Ya’u.

HIV Handbook for Everyone: Understanding, Preventing, and Living with HIV available in English and in Hausa.

Click on a cover image to view and download the handbook.

Tell us what inspired you to create the HIV Handbook for Everyone. What is the importance of releasing it in both English and Hausa?

Nigeria continues to carry one of the highest HIV burdens globally, and this burden is compounded by persistently low health literacy across many communities. In practice, this means a significant portion of the population, often those already most socially and economically vulnerable, has limited or no access to accurate, evidence based information about HIV. Working closely within these communities made this gap difficult to ignore.

It became clear to us that health information, when made accessible and culturally grounded, can function as a genuine public health intervention in its own right.

This understanding was the foundation for developing a toolkit specifically designed to reach populations that conventional health communication has historically underserved.

How did you decide what you would include in the handbook? How did you ensure that the handbook included evidence-based information on HIV while being culturally appropriate?

Our starting point was foundational knowledge, an accurate, accessible explanation of what HIV is, how it is transmitted, and how transmission can be prevented. We approached this deliberately, as a strong grasp of the fundamentals remains the most reliable determinant of protective behavior; a reader who leaves with a clear, correct understanding of transmission and prevention has already gained something of real public health value. Building on this foundation, we incorporated emerging evidence on Lenacapavir based PrEP (LEN-PrEP), reflecting our commitment to keeping the handbook aligned with current advances in HIV prevention science rather than static or outdated guidance. Throughout the development process, we were equally attentive to how this information was communicated.

Content was reviewed and framed to reflect the language, lived experience, and cultural context of the communities we serve, so that the material reads as credible and relevant rather than clinical or externally imposed.

Who are you working with to disseminate this handbook? Are there community groups, medical facilities or peer navigators involved?

Dissemination has been a collaborative undertaking. We work with medical students trained as peer navigators across Kano State, who serve as trusted, community embedded intermediaries capable of contextualizing the material and addressing questions directly. This is complemented by partnerships with medical facilities, which allow the handbook to function not merely as a standalone resource but as a bridge into the formal health system, connecting readers to testing, counseling, and treatment services when needed.

What are the gaps in HIV education, prevention and treatment that you hope to help tackle with this handbook?

A central challenge in HIV response remains the persistence of misinformation and stigma, which often present a greater barrier to care seeking than the disease itself. Through this handbook, we aim to address prevailing myths, strengthen public understanding of transmission and prevention, and provide clear guidance on when and where to seek clinical care. Our broader objective is to narrow the distance between public perception of HIV and the current scientific understanding of it.

Do you have plans to measure the impact of disseminating this handbook? Any plans to expand the project to other languages or provide updated guides in the future as new HIV prevention and treatment technologies become available?

Yes. This handbook is conceived as part of a sustained, iterative initiative under Youth Against HIV rather than a single output. We intend to evaluate its reach and effectiveness over time, and, contingent on further funding, to extend it into additional Nigerian languages, a meaningful undertaking given the country’s linguistic diversity, with well over 500 languages spoken nationally. We are equally committed to revising the handbook’s content as new prevention and treatment technologies emerge, ensuring it remains a living, evidence based resource rather than a fixed document.

Access the handbook in English >>

Access the handbook in Hausa >>

Designed for Scale: Winning Ideas to Accelerate Lenacapavir Uptake Among Youth in Africa

by Emily Hickner | May 26, 2026 | INSPIRE Designathon, Learning Core

Photos by Tobi Ishola.

Eight dynamic teams of research and community collaborators journeyed across Africa — converging on Lagos, Nigeria for the second annual INSPIRE Designathon Sprint. The energy was electric from the moment teams arrived, bringing bold ideas, deep community knowledge, and a shared passion to change the trajectory of HIV prevention and care for young people. Over three packed days (2-4 May 2026), INSPIRE team members and competing designathon teams dove into expert-led discussions, networking sessions, and tailored coaching — all focused on one transformative challenge: scaling up lenacapavir (LEN) for youth-centered HIV prevention and care across Africa.

LEN represents one of the most promising long-acting HIV prevention and treatment options. LEN is a highly-effective, twice-yearly injectable, which makes adherence easier and delivery more discreet. For adolescents and young adults grappling with access barriers, stigma, and the daily challenges of staying on treatment, LEN isn’t just a new drug — it’s a game-changer.

Similar to a hackathon, during this three-day, intensive sprint, teams work together to design and present their ideas. Eight semifinalist teams — selected from nearly 40 proposals for their innovative solutions — sharpened their project ideas using the guidance and support they have received from experts throughout the sprint. On the final day, teams delivered five-minute pitches to a panel of judges, fielding tough questions and defending their visions. Additionally, each team submitted a PLAN (People Learning, Adapting & Nurturing) diagram and executive summary.

After a careful and intense deliberation, three teams were selected for their originality, relevance, feasibility and scalability. These teams were awarded seed funding to pilot or implement their winning project ideas. Over the course of the next year, these teams will work with INSPIRE and their affiliated PATC³H-IN Clinical Research Center to bring their strategies to life.

Despite the progress made so far in preventing the transmission and care for HIV patients access Africa, access to these services are big issues, making it impossible to reach our young people. This designathon is dedicated to develop creative ideas on how to scale up and sustain HIV interventions for adolescents and young adults.

– Juliet Iwelunmor, INSPIRE Director

Three Winning Designathon Teams

All eight designathon teams pose with INSPIRE team members and coaches from the event.

Designathon participants and supporting faculty and staff

Team Hair Salon embraces INSPIRE Director Juliet Iwelunmor

Designathon Sprint judges

Meet the winning teams

Hair Salon

South Africa | ATTUNE

Team Hair Salon is comprised of Kananelo Lehlohonolo Moshabesha, Mamaswatsi Pearl Kopeka, Charné Petinger and Yolanda Mayman. They seek to address the critical gap in youth-friendly, stigma-free, and trusted access points for HIV prevention information and services by shifting access from clinical spaces to trusted, community-based environments, improving the acceptability, accessibility, and uptake of Lenacapavir among adolescent girls and young women. Their unique approach involves using braiding salons, which are existing community-spaces, as venues for delivering information about LEN without the stigma associated with healthcare facilities, and with the help of trained trusted stylists. Hair Salon is reimagining HIV prevention delivery by shifting the conversation from clinical to personal.

It was a dynamic experience with dynamic people. It facilitated growth… All of us (the teams) were talking and brainstorming amongst each other.

– Charné Petinger, Hair Salon

Team NEXUS

Nigeria | iCARE Plus

Team Nexus consists of Sulaimon Afeez Olatunji, Offor Gab-Cliton Nwakobi, Oluwafemi Adeshina, and Hannah O. Smart. Their project — SafePass Lagos — aims to pilot a gamified youth-centered LEN delivery model that can be replicated across Africa. SafePass is designed for young men who engage with sex with men and currently have an HIV-negative status. In a system that does not consider this particularly vulnerable population, which is at a 16-times higher risk for contracting HIV, SafePass has been built with the input of its target community. This community faces daily pill adherence burden, stigma and discrimination, and delayed care — all contributing to low PrEP rentention. The SafePass app aims to overcome logistical barriers — like low bandwidth — and structural barriers — like criminalization — with a privacy-first design that work on slow Internet networks. The app takes specific problems such as patients fearing their name being called in waiting rooms and targets them with concrete solutions such as anonymous check-in with a QR code. Team Nexus has proposed a scalable solution that addresses the unique needs of its community and offers actionable solutions.

As a team, we recognize each person’s strengths and make the best use of them.

– Sulaimon Afeez Olatunji, Team NEXUS

Team MyCare

Nigeria | S-ITEST

Team MyCare —Mobilizing Youth On Campuses For Lenacapavir Access, Uptake, and Referral — is Johnson Davidson Chukwuemeka, Olaoluwaposi Ogunlana, Halimat Olaniyan, and Victor Oluwafemi Femi-Lawal. Their project address the access gap young people in Nigeria face by designing with youth, rather than just for them. They do this by co-creating culturally-relevant materials, promoting on school campuses and other youth-friendly spaces, using a WhatsApp referral system, and deploying 30 trained and trusted peer influencers to drive the conversation. The project works when students scan a QR code on a poster to confidentially message MyCare on WhatsApp. The student is connected with a competent peer navigator who conducts a brief risk assessment and provides stigma-free information. The student is then linked to a trusted facility for a LEN screening and care. Team MyCare redefines how we deliver public health to young people through a scalable blueprint that meets youth where they are.

For me and my team, MyCare, the Designathon was a transformative experience. From learning about co-creation methods to the opportunity to gain insights from implementation science experts, I felt empowered about the ability of young people to be a part of the solution to the HIV epidemic in Africa.

-Victor Oluwafemi Femi-Lawal, Team MyCare

From Surviving to Thriving: The BeYOUtiful Mindz Movement

by admin | Apr 28, 2026 | INSPIRE Designathon

Written by the BeYOUtiful Mindz Team | South Africa

More Than Just a Project

For far too long, mental health conversations, especially among adolescents and young people, have been whispered in corners, shaped by stigma, or ignored altogether. But what if we shifted the narrative? What if survival was no longer the goal, but thriving became the standard?

This is the heartbeat of BeYOUtiful Mindz.

BeYOUtiful Mindz is not just another mental health initiative. It is a movement rooted in empathy, lived experiences, and the urgent need to create safe, accessible spaces for young people, particularly those navigating the complex realities of living with HIV. At its core, we recognize that young people are not just patients or statistics. They are individuals with dreams, fears, identities, and voices that deserve to be heard.

What We Set Out to Do

Our goal has been simple but ambitious. We aimed to integrate mental health support into existing adolescent HIV services in ways that are practical, accessible, and sustainable.

We trained lay counsellors, peer mentors and community health workers to deliver basic mental health support through psychoeducation and structured counselling approaches. By embedding this support within clinics, communities, and youth spaces, we hoped to bring care closer to where young people already are.

This approach allows mental health care to feel more relatable and less intimidating, while also strengthening the existing support systems around young people.

What We Have Learned So Far

As the Designathon continues towards June, our journey has been shaped as much by challenges as by progress.

One of our earliest lessons was that context matters more than planning. During our first training sessions, we encountered a language barrier. While the training was expected to be delivered in English, many participants were more comfortable engaging in their home languages. This affected participation and understanding, reminding us that accessibility is not only about location, but also about language.

We also faced logistical challenges. Transport had been arranged through the Department of Health, but on the first day it was not available. We had to follow up with participants individually to ensure they could attend. Although many still arrived, this experience highlighted how quickly plans can shift in low-resource settings and how important flexibility is.

Another key challenge was perception. Many participants initially associated mental health only with severe and visible conditions. When we introduced psychoeducation, engagement was slow and uncertain. It became clear that before introducing tools and interventions, we needed to create a shared understanding of what mental health actually is.

These early experiences pushed us to adapt in real time. We moved our training venue from our office in Vincent to a decommissioned clinic in Mdantsane, closer to the community health workers and lay counsellors. The space was simple, but it was functional, with running water, electricity, desks, and chairs. More importantly, it was accessible.

This shift made a noticeable difference. Reducing the distance between participants and the training space improved attendance and engagement. It reinforced an important lesson. Proximity and convenience are not minor details. They are central to participation.

As the days progressed, we began to see change. Participants became more engaged, more open, and more willing to take part in discussions. Conversations that once felt hesitant started to flow more naturally. There was growing curiosity and a sense of ownership over the learning process.

This shift did not happen overnight. It required patience, adaptation, and continuous support. It also showed us that resistance is not rejection. Sometimes it is simply unfamiliarity.

Why This Work Matters

Through this process, we have been reminded why integrating mental health into HIV care is so important. Survival often looks like attending clinic visits, adhering to treatment, and managing daily challenges quietly. But thriving goes beyond that.

Thriving means feeling seen, understood, and supported. It means having the language to express emotions, the confidence to seek help, and the ability to build meaningful connections.

By working through peer mentors, lay counsellors and community health workers, we are helping to create spaces where young people can share their experiences without fear of judgment. These spaces are not just about support. They are about connection, identity, and belonging.

Looking Ahead

As we approach the final months of the Designathon, we carry forward the lessons we have learned so far. We have learned that flexibility is essential, that community voices must guide implementation, and that meaningful change takes time.

We are continuing to refine our approach, strengthen engagement, and build confidence among those delivering the intervention. Each challenge has helped us better understand what it takes to make mental health support work in real-world settings.

BeYOUtiful Mindz is not only about addressing mental health challenges. It is about changing how young people experience care. It is about creating a shift from surviving to thriving, one conversation, one session, and one connection at a time.

Because thriving is not a privilege. It is a right.

Meet the 2026 Designathon Teams

by Emily Hickner | Apr 14, 2026 | INSPIRE Designathon, Learning Core

This May, eight teams will travel to Lagos, Nigeria for INSPIRE’s three-day Designathon Sprint to hone and pitch their ideas on scaling up lenacapavir (LEN) for youth-centered HIV prevention and care across Africa. These teams represent four African countries and six PATC³H-IN clinical research centers. They were selected by a review team of experts from nearly 40 submissions to our open call for proposals. Their proposals were judged on:

Proposal clarity and logic
Significance- relevance, impact, projected outcomes
Innovation
Feasibility and rigor
Team capacity, professional goals, and composition

Teams will spend two days learning from experts in the field and refining their ideas. On the third and final day of the sprint, teams will pitch their ideas to a panel of judges for the opportunity to be one of three teams awarded up to US$10,000 to implement their project ideas over the course of a year.

Read on to learn about these teams and their exciting project ideas.

Meet the Teams

BioSecure

Nigeria | RISE

Hassan Oladipupo Ismail | Ighorodge Victory Christopher

As medical students and youth leaders, BioSecure recognizes that biological efficacy means little without last-mile delivery. Their project — BioSecure: Pulse — aims to decouple PrEP delivery from congested, stigmatized healthcare facilities by shifting delivery directly to the community level. This project leverages an offline-first, multi-sectoral digital logistics platform to transform community pharmacies into discreet, last-mile delivery nodes for youth. To maximize youth integration, users access the service branded as “Sexual Wellness & Lifestyle Protection” rather than a clinical HIV program. They book discreet time slots to minimize wait times and visibility, while a gamified “Pulse Points” system incentivizes their crucial six-month return visits with immediate rewards like data bundles.

Hair salon

South Africa | ATTUNE

Kananelo Lehlohonolo Moshabesha | Mamaswatsi Pearl Kopeka | Charné Petinger | Yolanda Mayman

Adolescent girls and young women (AGYW) in South Africa are at a disproportionately higher risk of acquiring HIV than their male counterparts. This inequity is caused by a myriad of structural and cultural factors that impact the burden on AGYW. Despite the elevated risk, AGYW are hesitant to use PrEP. There is a need for trusted community-based, stigma-free spaces that provide accurate information about PrEP and link young people to LEN. Team Hair Salon seeks to use the salon space for providing access to information about LEN without the stigma associated with healthcare facilities, and with the help of trained trusted stylists.

PeerLEN Tanzania

Tanzania | MWOTAJI

Winfrida Onesmo Akyoo | Raphael Ruseke | Frank Immanuel Mhando | Haji Rajabu Mushi

PeerLEN Tanzania aims to co-design and implement a peer-led LEN delivery model tailored for adolescent girls and young women (AGYW) ages 18–30 who work in hospitality and entertainment venues in Dar es Salaam. This population faces barriers — including stigma, mobility, economic dependence, pill burden, and daily dosing fatigue — which have historically undermined adherence to daily oral PrEP. Guided by the Exploration, Preparation, Implementation, Sustainment framework and grounded in Social Cognitive Theory and the Andersen Behavioral Model, PeerLEN’s intervention integrates peer modeling, community engagement, and facility-based clinical delivery. By embedding LEN delivery within trusted youth social networks rather than parallel health systems, PeerLEN Tanzania will produce a scalable, sustainable model adaptable across African urban settings.

SafeSix

Uganda | MUJHU

Wandera Uthmaan Muluga | Namatovu Angella | MUSOKI DRAKE | MWEMEKE OSCAR

SafeSix works at the intersection of frontline HIV service delivery and research. Their low-cost, peer-anchored intervention is designed to support young adults in African settings to maintain their six-month LEN injection schedule for HIV prevention. The project uses a peer-anchored continuity package, including reminders from a trained peer and a neutral appointment card to protect privacy and reduce stigma. This model is designed to integrate seamlessly into existing youth-friendly clinics and community services. SafeSix addresses the core implementation challenge of long-acting HIV prevention — ensuring young people consistently return for injections and remain protected over time. The team’s long-term goal is to develop and test delivery innovations that can be integrated into sustainable prevention programs.

Team Catalyst

Nigeria | iCARE PLUS

Adeniyi Olayinka Abidemi | AMAO ADEBAYO OLAWUWO | Olayemi Tosin Akinpelu | Isaac-Ironondu Mmeli Victory

Team Catalyst’s proposed project — LENApp — aims to prototype a digitally enabled, peer-powered ecosystem that transforms how adolescents and young adults engage with PrEP—shifting from clinic-centered delivery to youth-centered access. The team plans to work with existing HIV and PrEP programs across the six geopolitical zones of Nigeria to identify and reach out to young people who are eligible for LEN via peer navigators. Those who start LEN will gain access to the mobile platform, which will send them appointment reminders, provide health information, and allow users to report side effects or ask questions confidentially. Lastly, the team will bring LEN closer to young people by offering it in adolescent-friendly clinics, community outreaches, and safe spaces.

Team MyCare

Nigeria | S-ITEST

Johnson Davidson Chukwuemeka | Olaoluwaposi Ogunlana | Halimat Olaniyan | Victor Oluwafemi Femi-Lawal

Team MyCare’s experience working with adolescents and young adults has taught them the importance of involving young people in designing delivery models. Their project will test a youth-led communication and peer navigation approach embedded within university campuses and linked to pharmacies and youth-friendly centres. By adapting the peer navigator model and expanding access points beyond traditional key population networks, their approach strengthens awareness, improves confidential linkage, and situates LEN within broader HIV prevention services. Because similar structural barriers exist across many African countries, this model offers a practical pathway for integrating LEN into youth-centered HIV care across the region.

Team NEXUS

Nigeria | ICARE PLUS

Oluwafemi Adeshina | SULAIMON AFEEZ OLATUNJI | Hannah Olumayomikun Smart | Offor Gab-cliton Nwakobi

Team Nexus’ project — SafePass Lagos — aims to pilot a gamified youth-centered LEN delivery model that can be replicated across Africa. Using an anonymous mobile app, Team Nexus will enroll at-risk youth via peer networks and conduct telehealth HIV screenings. Eligible participants receive an initial LEN dose at the clinic and a weekly reminder system with incentives to enable them to return for the second dose in six months. Each weekly check-in earns points redeemable for essentials (data bundles, transport vouchers, etc.), leveraging evidence that even small financial rewards greatly boost adherence. Using data collected through SafePass, Team Nexus aims to generate an open-source toolkit showing how to integrate LEN into existing youth programs.

Team REACH

Nigeria | S-ITEST

Olowu James Ochoyoda | EDIONWE MIRACLE OSASENAGA | Ruth Yetunde Daniel | Idoko Philip

Team REACH is committed to bridging the gap between biomedical innovation and implementation for adolescents and young adults in Nigeria. Evidence from prior HIV prevention rollouts shows that biomedical innovations frequently reach adolescents and marginalized youth last when delivery systems remain clinic centered. Team REACH seeks to address this challenge through their Youth-Integrated Lenacapavir Delivery Model (Y-LAP). Y-LAP utilizes peer ambassador-led awareness; risk screening on digital engagement platforms, pop-up and mobile clinics operating as extensions of licensed facilities in trusted youth spaces; and trained navigators to support return visits. This integrated model reduces structural barriers to access while maintaining clinical quality and regulatory compliance.

Tugambe, Talk to Us

by admin | Mar 23, 2026 | INSPIRE Designathon

Written by: Patricia M. Nabifo, Ochen Eric, Kintu Timothy Mwanje, Raymond Bernard Kihumuro | Team Tugambe

Tugambe is a word in Luganda that means “talk to us.” The phrase captures a reality we kept missing in HIV clinics. Imagine this: a teenage girl sits across from a healthcare provider who is rushing to keep up with a long queue of patients. Her viral load is reviewed and her medication is dispensed, but no one asks how she feels. Antiretroviral therapy keeps her body healthy, yet the health of her mind often remains unseen.

Here’s something most people don’t know: Up to one in three young people living with HIV in sub-Saharan Africa experience depression. As young adults with a medical background in HIV care, our team recognizes that depression is a significant concern. Because depression is quiet, it is easy to miss. Crowded waiting rooms, ten-minute consultations, and overwhelmed providers create a system where mental health gets pushed aside. We had to do something.

The turning point came when we were accepted into the INSPIRE Designathon. Suddenly, there was space to think differently. We asked the simple questions: What if mental health screening did not have to compete with busy clinics and limited time? What if young people could engage on their own terms, privately and without pressure?

These questions led us to Interactive Voice Response (IVR). IVR is not glamorous. It does not require smartphones or internet access. It is the same technology behind appointment reminders and automated phone menus. We believed its simplicity is its strength. A young person can call from any phone, listen to prompts in their own language, and respond using their keypad. No forms. No waiting rooms. No eyes watching.

Hand texting on phone.

Still, we did not know whether this approach would feel acceptable, which language would feel safe, or whether an automated system could be trusted with something as personal as emotional wellbeing. So instead of quickly building, we chose to slow down. We focused on formative work. The goal became listening before designing and learning before scaling.

As the idea took shape, we told our story; this time in a competitive pitching space. We shared not only the idea, but also the uncertainty behind it. We spoke honestly about our concern for young people living with HIV and our belief that IVR could help surface depression earlier. Emerging among the winners mattered. It gave us confidence and direction. It also helped us see this work beyond a single pilot. Our vision now stretches over the next several years, with the goal of making depression management a routine and integrated part of HIV care.

Progress, however, has not been straightforward. Like much research in Africa, one of the biggest challenges has been navigating ethics and regulatory approvals. As early career researchers, we have learned how slow, political, and demanding these processes can be. Inefficiencies within regulatory systems can delay promising work and strain limited resources. Learning how to maneuver these structures without losing momentum has required patience and resilience.

Beyond approvals, this journey has taught us how to pitch ideas clearly, how to develop community engagement plans that go beyond checklists, and how to listen during monthly engagements rather than defend assumptions. We have built new relationships, expanded our networks, and learned to recognize opportunity when it appears. So far, the work has been less about technology and more about people, trust, and learning to sit with uncertainty.

We now look ahead to securing institutional ethics approval and national regulatory clearance so the research can begin. That step matters, but it is not the point of this work. The point is whether young people living with HIV finally have a safe way to say how they are really doing.

This journey has taught us one clear lesson. Mental health in HIV care will not improve by adding more tasks to already overstretched clinics. It will improve when systems are designed to listen. If Tugambe succeeds in doing just that, in creating space for young people to speak without fear, interruption, or judgment, then it will have done something far more important than deploying a tool. It will have broken the silence.

The Fragility of Peer Power: What an IDP Camp Taught Us About Youth-Led HIV Outreach

by admin | Mar 17, 2026 | INSPIRE Designathon

Written by: Julianah Adebisi and Miracle Adesina | IMPACT Team, Nigeria.

We didn’t notice it at first, but something had changed.

Just weeks earlier, Zainab had become a major driving force behind HIV outreach in the camp. Young people were showing up to discussions. Her peers listened, showed up, and stayed engaged.

“Zainab” engaging her peers during an HIV outreach session in the camp. Peer trust is often the foundation of youth health programs.

There was energy, the kind you hope for when working with peer-led models.

Then, a personal conflict disrupted those relationships, and with it, the flow of new participants into the program.

Our most successful outreach channel had slowed to a halt.

That moment made us rethink what we thought we understood about peer-led models, especially in displacement settings.

Why we chose a peer-led approach

Young people often learn about sex, relationships, and risk from their peers long before they encounter formal health services. Peer-led outreach taps into these existing social networks. The logic is simple, versatile, and compelling: young people trust their peers, understand each other’s realities, and communicate information in ways that feel relatable.

For the Innovative Mobilization and Participatory Action for Community Transformation (IMPACT) project, this approach felt especially appropriate as we worked with young people living in Internally Displaced Persons (IDP) camps in Nigeria.

We trained a small group of youth champions and encouraged them to reach out to peers in their own social circles: friends, neighbours, and classmates at camp. It was a snowball approach. Each young person could bring others.

It seemed to work; we were gaining momentum.

Where we hit a wall

One champion stood out. Zainab was motivated, well-respected, and committed to the project. Through her efforts, we saw a noticeable increase in participation. Her peers listened to her. They showed up. Momentum began to build.

Without realizing it, we began to rely heavily on her network.

So, when conflict emerged from within her circle, the impact rippled outward. She stepped back from active recruitment. The peers she had mobilized became less engaged. New participants stopped coming.

At first, it felt like a setback. We had invested in training. We had seen progress, and now the progress was slowing.

However, with reflection, we realized that this wasn’t a failure of Zainab or her peers.

It was a gap in our project design.

What this taught us about peer networks

Peer-led models often assume that social networks are stable. In some communities, that may be true. However, in IDP camps, relationships live under constant strain.

Young people are navigating economic stress, family trauma, uncertainty about the future and competition for limited resources. These pressures do not stay outside the room when we hold HIV sessions; they affect how young people relate to each other.

In that environment, small disagreements can grow quickly.

Emotional strain is high, and when leadership is concentrated in one person, a single strained relationship can stall momentum.

What slowed our outreach was not resistance to HIV education. It was the fragility of relationships in a high-stress setting.

An illustration of shared leadership in youth outreach. Programs are strongest when responsibility is distributed.

An illustration of shared leadership in youth outreach. Programs are strongest when responsibility is distributed.

Rethinking how we support youth champions

The situation compelled us to reassess our support for young people who assume leadership roles in health programs.

Being a youth champion is more than delivering information; it means managing friendships, expectations, and sometimes tension, all while mobilizing others.

From this experience, we learned that peer-led models work better when leadership is distributed, rather than concentrated. Recruiting champions in clusters makes the program less vulnerable to the ups and downs of a single relationship.

We also learned that conflict is not a disruption to community work but a part of it. Creating space for early conversations, mentorship, and mediation matters more than we initially realized.

Designing youth health programs for real-life complexity

In displacement settings, health education competes with urgent daily needs influenced by economic pressure, emotional stress, and unstable social relationships, all of which affect how young people engage with HIV prevention.

Peer-led approaches need to be designed with flexibility and empathy, recognizing that health is only one part of what young people are dealing with every day.

Our experience reminded us that effective youth health programming in humanitarian contexts requires careful design, including:

Avoiding over-reliance on one champion
Investing in supporting relationships, not just training
Linking HIV outreach with livelihood support, psychosocial services, and other programs that respond to young people’s everyday realities

Moving forward

The setback in our recruitment was not the end of the story.

It pushed us to distribute leadership more intentionally, to check in more frequently with our youth champions, and to treat relational dynamics as part of program design.

Peer power remains one of the strongest tools in youth HIV prevention.

However, these peer-led models are only as strong as the relationships that sustain them.

Youth champions and participants during outreach. Peer power continues, strengthened by shared responsibility.

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