Nurturing Culturally-Salient Youth Narratives on HIV Self-Testing Uptake

The mission of 4 Youth by Youth (4YBY) is to continue to push youth-engaged research forward. Youth-participatory research gives voice to youth and allows freedom of expression and formulation of new ideas that may otherwise be missed. When thinking about new health solutions, such as HIV self-testing (HIVST), promoting youth-engaged findings about such solutions allows others to see things from the cultural landscape that shapes youth ideas. 4YBY recognizes that culture matters to young people and promoting such culture is important when youth decide to participate in a new activity or engage in different behaviors. 4YBY encourages young people to embrace their culture while recognizing that their ideas can transform future generations. 

The 4YBY study team works in various capacities, and one of these includes sharing findings about youth-engaged research at national and international conferences. Data from the 4YBY 2018 HIV World AIDS Day contest in Lagos, Nigeria, was recently presented at the national 2021 Society for Public Health Education (SOPHE) Annual Conference on April 29, 2021, by a 4YBY and I-TEST Saint Louis University (SLU) doctoral student team member, Stacey. The qualitative study, “Understanding factors that promote uptake of HIV self-testing among young people in Nigeria: Framing youth narratives using the PEN-3 cultural model,” combined the creative narratives of young people within the 4YBY crowdsourcing contest to promote HIVST uptake in Nigeria to answer the question: “How might we promote HIVST among young people aged 14-24 in Nigeria?” 

To promote health solutions like HIVST among young people, it is important to know the cultural context that shapes the way young people think about HIVST. To this end, the presentation was situated within the PEN-3 cultural model which centralizes culture in everyday lay meanings of health (1). Findings from the study highlighted the positive, existential or unique, and negative perceptions, enablers, and nurturers of HIVST among young people in Nigeria.

Emerging themes that guided youth narratives around ways to promote HIVST uptake among young people in Nigeria, 4YBY Presentation from the 2021 SOPHE annual conference

A positive perception of HIVST that a young person noted was the following:

“The HIV test kit has the potential to increase access to HIV testing. It gives one convenience and privacy and it’s very easy to use. It can also be beneficial to people who don’t have easy access to health centers”

A positive enabler included:

“We can harness the way social media has linked young people all over the world in discussions about issues that directly affect them. Spurring interest and awareness of HIV self-testing, can lead to conversations about it among young people”

Thus, a positive nurturer was:

“…Students are the ones that will still go back to their local area, home, friends, mosque or church and people cherish them as student of knowledge a lot and they influence others a lot”

An existential, or unique, perception of HIVST that a young person noted was:

“One of such ways is by placing detailed advertisements on radio programs, television stations, and newspapers; explaining vividly on the importance and benefits of this self-test, as well as how to carry it out”

A unique enabler was:

“Companies producing these drugs can partner with authenticated companies producing such toolkits so that controlled access to the equipment is made possible to prevent inefficient or fake toolkits from reaching the hands of youths to avoid turnout of wrong HIV test result” 

And a unique nurturer was:

“Teamwork which would involve parents and the society would help in promoting self-testing among youths, encouraging the intervention of the kit” 

More so, a negative perception of HIVST that a young person shared was:

“Say no to HIV stigmatization, after the test has been done individuals with HIV should not be treated as an outcast, they should not be stigmatized because of this stigmatization most of our youth are afraid to know and check their HIV status”

A negative enabler included:

“Crucial that provision of pre- and post-test counseling should be made available in order to avoid misinterpreting the instructions… people might commit suicide if they received positive HIV self-testing results without formal support from a health care provider or counselor… no referral mechanism to link them to a healthy facility after self-testing”

And a negative nurturer was:

“Unfavorable reaction of partners in relationships and marriages also make people scared of knowing their status especially when the kit can show their path at their comfort zones”

The presentation highlighted the use of the PEN-3 cultural model to better understand cultural revelations around HIVST promotion among Nigerian youth. The findings portrayed the cultural resources available to young people as they make sense of HIVST and in their communities. Incorporating young people’s voices to better understand health interventions like HIVST is important when thinking about uptake among young people in low-resource areas and understanding barriers and facilitators for youth as they engage in various health interventions and when ensuring sustainability. 

The SOPHE 2021 annual conference was held digitally from April 6-9, 2021, with additional sessions towards the end of April and beginning of May. The theme of this year’s conference was “Gateway to the Future: Health Education & Promotion for All.” SOPHE brings together public and school health education professionals to gain the latest research and best practices and practical application (2).

We at 4YBY are committed to advancing youth voices when sharing research findings and understanding the cultural context that shapes youths’ ideas. We are excited for what the future holds for 4YBY and even more excited for youth to continue to lead when creating new health ideas for years to come.


  1. Airhihenbuwa, C., Okoror, T., Shefer, T., Brown, D., Iwelunmor, J., Smith, E., Adam, M., Simbayi, L., Zungu, N., Dlakulu, R., & Shisana, O. (2009). Stigma, Culture, and HIV and AIDS in the Western Cape, South Africa: An Application of the PEN-3 Cultural Model for Community-Based ResearchThe Journal of black psychology35(4), 407–432.
  2. SOPHE. (2021). Gateway to the Future: Health Education & Promotion for All. Retrieved 4 June 2021 from

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