Reimagining HIV Prevention for Young MSM: Three Transformative Approaches from Kenya and Mexico
Photo by Patrick Pierre on Unsplash
When it comes to advancing HIV prevention and care, one of the greatest challenges lies in engaging young men who have sex with men (YMSM) – particularly those aged 15-19.
When a 15-year-old confides, "I changed my mind not to have my HIV test results because I wasn't ready to come to be on ART in case I happen to test positive," we get a snapshot into the complex web of fears, stigma, and barriers that keeps many YMSM from accessing critical healthcare services.
For many YMSM the fear of being outed or judged can overshadow the need for critical health services.
In some countries, YMSM struggle to find unbiased healthcare due to stigma and criminalization of same-sex sexual activity. Yet, our Almasi pilot in Kenya and our campaign in Mexico, has shown that with the right approach, barriers can be broken and that YMSM are willing to engage when they feel seen, respected, and safe.
1. The Trust Multiplier: Leveraging Peer Networks for Health Access
Engaging YMSM, particularly minors, requires overcoming significant barriers from fear to mistrust. In close-knit communities like Kisumu, where being outed can have serious consequences, innovative approaches have been central to safety.
The first step during the Almasi pilot with our partner Maaygo, was to focus on building trust through in-person sensitization. YMSM aged 15-19 were guided through the HIV testing process with clear and transparent communication. They were then encouraged to spread the word within their social circles through a peer-to-peer snowball strategy. This approach turned out to be highly effective: nearly 60% of the pilot’s HIV test deliveries were the result of in-person outreach, highlighting the importance of trust-building efforts.
Through this pilot, we proved that by creating safe spaces for conversations and fostering trust among peers can increase HIV testing. It’s a testament to the power of meeting people where they feel most secure—both physically and emotionally.
Key insights:
Trust-building must precede any health intervention
Peer networks can create protective social circles that normalize HIV testing
In-person sensitization creates deeper, more lasting engagement than digital-only approaches. Privacy isn’t optional, it’s essential
2. Centering Self-Care: Framing HIV Testing as a Celebration, not an Obligation
Perhaps our most counterintuitive discovery was that the traditional, clinical approach to HIV testing actually reinforces stigma with YMSM. Testing and treatment often carry a heavy stigma, deterring many YMSM from seeking care. Reframing HIV testing as a positive step towards a healthier, more fulfilling life turned out to make all the difference. This revolutionary approach positioned HIV testing within a broader context of personal growth and achievement–and something worth celebrating. Our partners Maaygo and Hoymas embraced this approach by organizing social events where HIV services were integrated seamlessly. These events would offer non-HIV-related incentives, such as economic mentorship. Doing so created an environment where testing felt less like a burden and more like a gateway to a prosperous future. At these events there were incentives like condoms, lubricant, and airtime which reinforced the celebratory atmosphere.
Beyond increasing testing rates, these events provided crucial infrastructure for follow-up care, which ensured participants stayed connected to health services. By making testing feel like a milestone worth celebrating rather than another box to check off, we showed that taking charge of your health can be a powerful step toward the future you want.
“I propose that recreational activities be part of linking to care and treatment. It should not just be seen as a routine and something that is mandatory, but rather a joyous activity that we YMSM enjoy.”
Key insights:
Shifting HIV testing from a clinical task to a celebratory milestone makes it more approachable
Social events not only increase testing rates but also establish vital pathways for follow-up care
Positioning HIV testing within the broader context of personal growth and achievement motivates YMSM to view it as an empowering step toward a better future
3. Digital Engagement that Works: Meeting YMSM In Their Digital Spaces
For YMSM in Mexico, accessing reliable information about HIV prevention often felt out of reach. To address this, in partnership with CISIDAT, we launched a multi-platform digital campaign with tailored strategies ranging from Facebook and TikTok. The campaign’s goal was to share tailored content that was both engaging and accessible.
The campaign tackled fears and misconceptions about PrEP—a key HIV prevention tool—by creating ads that resonated with YMSM. These ads provided clear steps to connect with local clinics. Within just a few weeks, the campaign saw over 470 inquiries about PrEP, with more than 40% expressing serious interest, and nearly 25% scheduling appointments with community-based organizations.
By meeting YMSM where they already spend their time and in a language that speaks to them, the campaign demonstrated how social media can effectively bridge gaps in access to healthcare and drive behavior change. It also highlighted the importance of understanding the unique challenges and preferences of this audience, making HIV prevention more approachable and actionable.
Key insights:
Social media platforms can be used as a tool to effectively address the lack of accessible HIV prevention information by meeting YMSM where they already spend their time
Content that resonates with the audience—addressing fears and misconceptions about PrEP—leads to meaningful action, such as inquiries and appointments
Providing straightforward steps to connect with clinics ensures that interest translates into tangible healthcare engagement
Looking ahead
The work of engaging YMSM goes beyond clever strategies and well-designed campaigns. It’s about understanding their fears, hopes, and daily realities. It’s about creating spaces where they feel safe to ask questions, make informed choices, and see testing and care as tools for a better future.
From our work, one thing is clear: change happens when we meet YMSM where they are—whether it is in their communities, at events with their friends, or on their phones.
Interested in learning more about YLabs’ work to help youth lead the way? Check out our projects!
