Background Youth participation is critical to improving HIV prevention outcomes, yet evidence on the quality of adolescent and young adult (AYA) participation in HIV self-testing programs in low- and middle-income countries remains limited. This study assessed levels and correlates of AYA participation in HIV self-testing interventions implemented in Nigeria. Methods We conducted a secondary analysis of data from the Innovative Tools to Expand Youth-friendly HIV Self-Testing study, which recruited AYA aged 14–24 years from four Nigerian sites (September 2019–March 2020). Participation was measured using an adapted 12-item Tiffany–Eckenrode Program Participation Scale across four domains: ownership, voice/influence, support and community participation. Scores ranged from 0 (strongly disagree) to 4 (strongly agree) and were categorized as minimal (3.5), moderate (3.5–4.0) or substantial (4.0). Chi-squared tests examined associations between participation levels and sociodemographic variables, with Cramér’s V summarizing effect sizes. Results Among 388 AYA (mean age 21 ± 2 years; 58% male), overall participation was high (M = 4.04 ± 0.24). Domain-specific analyses showed substantial participation in support (M = 4.08 ± 0.23), community participation (M = 4.04 ± 0.24) and ownership (M = 3.94 ± 0.27), whereas voice/influence was moderate (M = 3.87 ± 0.32). Education (χ2 = 43.23, P 0.001; V = 0.33), employment (χ2 = 122.70, P 0.001; V = 0.56) and income (χ2 = 119.68, P 0.001; V = 0.55) were significantly associated with participation, whereas age, sex and marital status were not. Conclusion These findings highlight generally high AYA participation in HIV self-testing interventions, but underscore socioeconomic disparities that may shape participation quality. Programs should prioritize equitable engagement strategies for youth with fewer resources.
Nkengasong et al. (2026) studied this question.