Y-FIT Ghana: A Study Protocol for a Youth-Led Participatory Approach to Promote Youth-Friendly HIV Self-Testing, Oral and Long-Acting Injectable Pre-Exposure Prophylaxis Uptake in Ghana

IntroductionDespite progress in HIV prevention, adolescents and young adults in sub-Saharan Africa remain disproportionately affected by HIV. In Ghana, youth aged 15-24 years face persistent barriers to accessing HIV prevention services, including stigma, limited awareness of prevention options, and insufficient availability of youth-friendly services. Emerging and existing prevention approaches, including HIV self-testing, oral, and long-acting injectable pre-exposure prophylaxis offer important opportunities to reduce HIV infections among youth. However, successful uptake depends on delivery strategies that reflect young peoples priorities and lived experiences. The Youth-Friendly Innovation Tools for HIV Prevention in Ghana (Y-FIT Ghana) study uses a youth-led, participatory approach to co-create strategies that support youth-friendly HIV self-testing and PrEP uptake. MethodsY-FIT Ghana is a mixed-methods, participatory study grounded in Youth Participatory Action Research and Human-Centered Design, and guided by Social Cognitive Theory. The study will follow a three-phase innovation pipeline: (1) a national open call to solicit youth-generated ideas related to HIV prevention; (2) an HIV Innovation Sprint to refine and develop selected concepts; and (3) a one-week bootcamp focused on capacity building and implementation readiness. Adolescents and young adults aged 15-24 years will be recruited nationwide and engaged as co-designers throughout the study. Data collection will include participatory activities, qualitative assessments, and implementation-focused measures to examine feasibility, acceptability, perceived appropriateness, and youth engagement related to HIV self-testing, oral PrEP, and LAI-PrEP. Qualitative data will be analyzed using thematic analysis, and quantitative data will be summarized using descriptive statistics, with integration across methods to inform refinement of youth-friendly HIV prevention strategies. Expected ResultsThe study is expected to demonstrate that participatory innovation can produce feasible, youth-driven HIV prevention solutions. Participants are anticipated to gain knowledge, leadership skills, and self-efficacy while developing innovative prototypes suited for youth-friendly delivery. Ethics and disseminationEthical approval has been obtained from the University at Buffalo (IRB ID: STUDY00009385) and the Ghana Health Service (ID NO: GHS-ERC-030/05/25) Institutional Review Boards. Findings will be disseminated through peer-reviewed publications, youth- and community-facing outputs, stakeholder engagement activities, and policy-relevant briefs to inform youth-centered HIV prevention efforts in Ghana and similar settings.