Adolescent and Young Adult Leadership and Engagement in HIV Strategy and Policy Development: Experiences from the...

Adolescents and young adults (AYA) face disproportionately worse outcomes along the HIV prevention and care continuum. Despite global commitments to AYA engagement, AYA remain underrepresented in research, programming, and policy development. We summarize recent innovations in AYA engagement within the HIV literature and reflect on the 2023 Blueprint Collaborative, a UNICEF/WHO/UNAIDS initiative where AYA (ages 10-30) shaped global adolescent HIV strategy.

Our review found examples of AYA engagement across the intervention life cycle, including in shaping research agendas, designing interventions, and building AYA capacity for sustainability. For the Blueprint Collaborative, which featured a AYA-led evidence synthesis and global open call, we assessed AYA engagement using the RIGHTS framework. A major strength of the Blueprint Collaborative was the robust AYA engagement, moving beyond AYA consultations to AYA leadership. AYA shared decision-making authority with adults as researchers, organizers, and open call judges. Through a "learning by doing" approach, AYA gained skills in research and multidisciplinary collaboration. Blueprint results were presented to senior leadership, developed into strategy, and disseminated through publications and AYA networks. AYA leadership can provide several benefits for AYA research and programming, such as institutionalizing community engagement, improving research relevance, and advancing equity. AYA are eager and capable of driving HIV strategy and policy, but senior partners should step back to enable these opportunities. Senior partners might better serve to support AYA leadership in strategic planning to align programming with AYA priorities and build research and advocacy skills.