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

Abstract Introduction Despite 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 people’s 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. Methods Y-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 Results The 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 dissemination Ethical 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.