Factors associated with use of community-based, peer-led sexual and reproductive health services by adolescent boys and young men aged 18–24 in Lusaka, Zambia

Introduction Adolescents and young people (AYP) aged 15–24 years have the least access to facility-based sexual and reproductive health (SRH) services, including HIV services. The Yathu-Yathu cluster-randomized trial (CRT) in Zambia tested whether a novel peer-led community-based approach increased knowledge of HIV status amongst AYP. In this nested case-control study, we aimed to identify factors associated with non-attendance to the Yathu Yathu hubs by adolescent boys and young men (ABYM) aged 18-24-years. Methods Yathu Yathu was a CRT conducted in two communities in Lusaka, Zambia, with 10 intervention and 10 control zones. AYP in all zones were offered prevention points cards (PPC), which incentivized and tracked service use at the hubs and health facility. In intervention zones, services were provided to AYP through community-based spaces (hubs) led by peer support workers. In these zones, cases were defined as those not having accessed any service at a hub and controls as those that accessed at least one service. Data were collected from October 2020 to January 2021 and analysed using methods appropriate for unmatched case-control studies. Results 161 cases and 160 controls consented to participate in the study. Participants aged 20–24 years (adjOR 1.99, 95%CI 1.26–3.12, p = 0.003), who were educated up to college level (adjOR 8.47,95%CI 2.08–34.53, p = 0.001) or who reported being employed in the last 12 months (adjOR 2.15, 95%CI 1.31–3.53, p = 0.002) were more likely to not attend the hubs. ABYM who had a friend with a PPC were more likely to attend the hubs (adjOR 0.18 95%CI 0.09–0.35, p Conclusions Despite Yathu Yathu services being community-based and more accessible compared to health facilities, we found age, education and employment were associated with not attending hubs. Strategies are needed to reach employed young men who may not have access to SRH/HIV services during conventional working hours and to better utilise peer networks to increase service use

Attendance · Environmental health · Family medicine · Population · Reproductive health · Adolescent Sexual and Reproductive Health · Demography · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Medicine · Nursing · Gerontology

• “A heart of the man is lighter than that of the woman…” exploring men’s motivation and capability to access HIV services in Lusaka, Zambia

  Open Access•Chisanga Mwansa, Mwelwa M Phiri et al.•BMC Public Health•2025

  Incluir item

• Peer providers delivering health and wellbeing services for adolescents and youth – a scoping review of implementation experience and impact from Eastern and Southern Africa

  Open Access•Chelsea Coakley, Elona Toska et al.•AIDS Care•2026

  Incluir item

• Detecting Alcoholism

  John A Ewing•JAMA•1984

  Incluir item

• What Role Do Masculine Norms Play in Men’s HIV Testing in Sub-Saharan Africa?

  Open Access•Katelyn M Sileo, Rebecca Fielding-Miller et al.•AIDS and Behavior•2018

  Incluir item

• Alcohol Use and Sexual Risks for HIV/Aids in Sub-Saharan Africa

  Open Access•Seth C Kalichman, Leickness C Simbayi et al.•Prevention Science•2007

  Incluir item

• Epidemiology of HIV and Aids Among Adolescents

  Priscilla Idele, Amaya Gillespie et al.•JAIDS Journal of Acquired Immune…•2014

  Incluir item

• A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa

  Open Access•Maurice Musheke, Harriet Ntalasha et al.•BMC Public Health•2013

  Incluir item

• Our future

  Open Access•George C Patton, George Patton et al.•The Lancet•2016

  Incluir item

• The role of conceptual frameworks in epidemiological analysis

  Cesar G Victora, Sharon Huttly et al.•International Journal of…•1997

  Incluir item

• Associations between alcohol misuse and risks for HIV infection among men who have multiple female sexual partners in Cape Town, South Africa

  Loraine Townsend, Samantha R Rosenthal et al.•AIDS Care•2010

  Incluir item

• “The difference that makes a difference”

  Open Access•Virginia Bond, Chiti Bwalya et al.•AIDS Care•2016

  Incluir item

• Leveraging incentives to increase HIV testing uptake among men

  Open Access•Alex Ndyabakira, Monica Getahun et al.•BMC Public Health•2019

  Incluir item

• Alcohol Consumption as a Barrier to Prior HIV Testing in a Population-Based Study in Rural Uganda

  Open Access•Robin Fatch, Ben Bellow et al.•AIDS and Behavior•2012

  Incluir item

• Uptake of HIV Testing Services Through Novel Community-Based Sexual and Reproductive Health Services

  Open Access•B Hensen, Mwelwa Phiri et al.•AIDS and Behavior•2021

  Incluir item

• Gender Norms and HIV Testing/Treatment Uptake

  Open Access•Julie Pulerwitz, Ann Gottert et al.•AIDS and Behavior•2019

  Incluir item

• Lessons learned from engaging men in sexual and reproductive health as clients, partners and advocates of change in the Hoima district of Uganda

  Open Access•Eliezer Stern, Laura Pascoe et al.•Culture Health & Sexuality•2015

  Incluir item

• The HIV Blind Spot

  Open Access•Tim Shand, Hayley Thomson-de Boor et al.•IDS Bulletin•2014

  Incluir item

• Measuring Peer Pressure, Popularity, and Conformity in Adolescent Boys and Girls

  Open Access•Darcy A Santor, Deanna Messervey et al.•Journal of Youth and Adolescence•2000

  Incluir item