A digital self-screening and education model to strengthen HIV prevention among adolescents

Adolescents in Indonesia remain disproportionately affected by HIV but face barriers to youth-friendly services due to stigma and structural constraints. This study developed and assessed a digital HIV education and self-screening model (EKSTRIM) for adolescents in Yogyakarta using a sequential explanatory mixed-methods design. A survey of 400 adolescents recruited through cluster random sampling was followed by focus group discussions with 16 adolescents and interviews with nine stakeholders. Findings showed high digital readiness: 98.2% had internet access, 97.2% owned smartphones, and 92.3% preferred web-based platforms. Audiovisual content was favored by 66.2%, while 57.3% had received HIV information digitally but none had been tested. Stakeholders supported digital approaches but noted challenges with consent, stigma, and sustaining peer involvement. A functional prototype was co-designed, integrating structured HIV modules, anonymous self-risk screening with automated feedback, and referral information. Adolescents emphasized simplified language and privacy features. Evaluation confirmed feasibility and acceptability, though not effectiveness. EKSTRIM demonstrates strong potential as a scalable, youth-friendly HIV prevention strategy in Indonesia and similar high-digital-engagement settings.