Innovative approaches for engaging adolescents in Primary HIV prevention: lessons from the peer-Led health education program in Nimule, South Sudan.

BACKGROUND: The involvement and engagement of adolescents in community-based HIV prevention programmes are crucial for enhancing the effectiveness and sustainability of these programmes yet few programmes have documented their engagement strategies. This study aimed to describe and innovative approaches used to actively engage adolescents in HIV prevention health education programmes designed to increase awareness of HIV prevention methods, reduce risky behaviours, and increase uptake of HIV testing. METHODS: We employed participatory approaches involving pre-programme consultations with adolescents’ peer educators and conducting post-programme reflection sessions. The pre-programme consultations were aimed at identifying objective opinions from peer educators on the best approaches for actively engaging peers in health education sessions. The post-programme reflection sessions involving peers were aimed at collecting feedback across eight approaches adopted to identify which of those motivated and actively engaged them in their groups. Thematic context analysis was used to identify and validate the most preferred approaches. RESULTS: Of the 50 participants, 27 (54%) were female and 23 (46%) were male adolescents. The participants were within the age range of 14–17 years. More than 90% of the adolescents identified that being in groups facilitated by a peer of the same gender, having a peer educator representing greater diversity, being in a group with flexible meeting dates, times, and venues, and staying connected were the major motivators for their active engagement in their groups. Conversely, having peer educators with good facilitation skills, finding mental health and psychosocial support, and having a sense of ownership of the group were the least rated motivators. CONCLUSIONS AND RECOMMENDATIONS: Employing approaches that enhance active participation can substantially improve adolescents engagement in HIV primary prevention interventions. This implies that employing a multifaceted and innovative approaches is a game-changer in actively engaging adolescents in community-based HIV programmes and hence the need to advocate for adolescents' engagement in HIV prevention as well as future research into approaches crucial in strengthening and scaling effective programmes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12978-025-02234-4.