"Go where the young people are": Assessing participatory engagement among young adults for HIV prevention.

BACKGROUND: To reduce the incidence of HIV, federal priorities aim to increase HIV testing rates, especially in high-risk jurisdictions. HIV self-testing (HIVST) is an evidence-based option that reduces barriers to facility-based testing. However, uptake of HIVST is low among young adults. PURPOSE: To describe participatory engagement processes applied to identify implementation strategies for expanding the uptake of HIVST among young adults in one urban county in the Southeast United States. METHODS: In-depth interviews with community members, providers, and young adults were conducted (February to December 2024). A matrix analysis was applied to identify themes pertaining to facilitators and barriers of engagement among young adults. Three engagement methods were facilitated: a community advisory group, crowdsourcing open call, and charrettes co-creation workshops (January 2024 to June 2025). The community engagement processes were grounded in a community-based participatory research approach. RESULTS: Three themes emerged from the in-depth interviews: the importance of community connections, best practices for community engagement, and multiplatform health communication strategies to engage young adults. The final implementation strategies identified were: training for support staff at implementing agencies, disseminating HIVST kits at community-wide pop-up events, and word-of-mouth dissemination. However, ongoing participation among young adults in the community advisory group was a challenge. CONCLUSIONS: The identified implementation strategies to promote the uptake of HIVST reflect ongoing engagement efforts facilitated by the research team. Findings highlight the need to investigate motivating factors for participation in ongoing HIV prevention, and to develop asynchronous modalities for engaging with young adults who have competing priorities.