Idigbe Ifeoma, Gbaja-Biamila Titilola, Asuquo Sarah, Nwaozuru Ucheoma, Obiezu-Umeh Chisom, Tahlil Kadija M, Musa Adesola Zaidat, Oladele David, Kapogiannis Bill, Tucker Joseph, Iwelunmor Juliet, Ezechi Oliver
Nigerian Institute of Medical Research, Lagos, Nigeria.
Saint Louis University, St. Louis, MO, United States.
JMIR Form Res. 2023 Jun 29;7:e38528. doi: 10.2196/38528.
UNAIDS (Joint United Nations Programme on HIV and AIDS) and the Nigeria National HIV/AIDS Strategic Framework recommend HIV self-testing and youth-friendly services to enhance HIV testing, linkage to health services, and prevention. However, the voices of youths are seldom incorporated into interventions. We examined qualitative data generated from a series of participatory events in partnership with Nigerian youths focused on enhancing linkage to care.
The aim of this study was to assess youth-initiated interventions developed during a designathon to improve linkage to care and sexually transmitted infection services.
This study conducted a designathon informed by crowdsourcing principles and the participatory research action framework. A designathon is a multistage process including an open call, a sprint event, and follow-up activities. The open call solicited Nigerian youths (14-24 years old) to develop intervention strategies for linkage to care and youth-friendly health services. A total of 79 entries were received; from this, a subset of 13 teams responded to the open call and was invited to participate in a sprint event over 72 hours. Narratives from the open-call proposals were analyzed using grounded theory to identify emergent themes focused on youth-proposed interventions for linkage to care and youth-friendly services.
A total of 79 entries (through the web=26; offline=53) were submitted. Women or girls submitted 40 of the 79 (51%) submissions. The average age of participants was 17 (SD 2.7) years, and 64 of 79 (81%) participants had secondary education or less. Two main themes highlighted strategies for enhancing youths' HIV linkage to care: digital interventions and collaboration with youth influencers. A total of 76 participants suggested digital interventions that would facilitate anonymous web-based counseling, text prompt referrals, and related services. In addition, 16 participants noted that collaboration with youth influencers would be useful. This could involve working in partnership with celebrities, gatekeepers, or others who have a large youth audience to enhance the promotion of messages on HIV self-testing and linkage. The facilitators of youths' linkage included health facility restructuring, dedicated space for youths, youth-trained staff, youth-friendly amenities, and subsidized fees. Barriers to HIV linkage to care among youths included a lack of privacy at clinics and concerns about the potential for breaching confidentiality.
Our data suggest specific strategies that may be useful for enhancing HIV linkage to care for Nigerian youths, but further research is needed to assess the feasibility and implementation of these strategies. Designathons are an effective way to generate ideas from youths.
联合国艾滋病规划署（联合国艾滋病毒与艾滋病联合规划署）和尼日利亚国家艾滋病毒/艾滋病战略框架建议开展艾滋病毒自我检测及提供对青年友好的服务，以加强艾滋病毒检测、与医疗服务的衔接及预防工作。然而，青年的声音很少被纳入干预措施中。我们研究了与尼日利亚青年合作开展的一系列参与性活动所产生的定性数据，这些活动聚焦于加强与医疗服务的衔接。
本研究旨在评估在一场设计马拉松活动中由青年发起的干预措施，以改善与医疗服务及性传播感染服务的衔接。
本研究开展了一场基于众包原则和参与性研究行动框架的设计马拉松活动。设计马拉松是一个多阶段过程，包括公开征集、冲刺活动及后续活动。公开征集邀请尼日利亚青年（14 - 24岁）制定与医疗服务衔接及对青年友好的医疗服务的干预策略。共收到79份参赛作品；其中，13个团队的子集回应了公开征集并被邀请参加为期72小时的冲刺活动。使用扎根理论对公开征集提案中的叙述进行分析，以确定围绕青年提出的与医疗服务衔接及对青年友好服务的干预措施的新出现主题。
共提交了79份参赛作品（通过网络提交 = 26份；线下提交 = 53份）。79份参赛作品中有40份（51%）由女性或女孩提交。参与者的平均年龄为17岁（标准差2.7），79名参与者中有64名（81%）接受过中等教育或以下教育。两个主要主题突出了加强青年艾滋病毒与医疗服务衔接的策略：数字干预措施以及与青年有影响力者的合作。共有76名参与者建议采用数字干预措施，以促进基于网络的匿名咨询、短信提示转诊及相关服务。此外，16名参与者指出与青年有影响力者合作会很有用。这可能包括与名人、把关人或其他拥有大量青年受众的人合作，以加强关于艾滋病毒自我检测及衔接的信息传播。青年与医疗服务衔接的促进因素包括医疗机构重组、为青年设立专用空间、经过青年培训的工作人员、对青年友好的便利设施以及补贴费用。青年在艾滋病毒与医疗服务衔接方面的障碍包括诊所缺乏隐私以及对可能泄露机密的担忧。
我们的数据表明了可能有助于加强尼日利亚青年艾滋病毒与医疗服务衔接的具体策略，但需要进一步研究来评估这些策略的可行性和实施情况。设计马拉松是从青年中产生想法的有效方式。
