{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:44:25Z","timestamp":1791935065111,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"S5","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":37,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV\u2010033650"],"award-info":[{"award-number":["INV\u2010033650"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 (5R01MH114560\u201003)"],"award-info":[{"award-number":["R01 (5R01MH114560\u201003)"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["224309\/Z\/21\/Z"],"award-info":[{"award-number":["224309\/Z\/21\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Despite the efficacy of antiretroviral therapy (ART)\u2010based prevention, population\u2010level impact remains limited because those at high risk of HIV acquisition are not reached by conventional services. We investigated whether youth\u2010centred and tailored HIV prevention, delivered by community\u2010based peer navigators alongside sexual and reproductive health (SRH) services, can mobilize demand for HIV pre\u2010exposure prophylaxis (PrEP) and ART among adolescents and young adults (AYA) in KwaZulu\u2010Natal, South Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Thetha Nami ngithethe nawe<\/jats:italic>\n                      is a cluster\u2010randomized stepped\u2010wedge trial (SWT) in 40 clusters within a rural health and demographic surveillance site. Clusters were randomized to receive the intervention in period 1 (early) or period 2 (delayed). Trained area\u2010based peer navigators conducted needs assessments with youth aged 15\u201330 years to tailor health promotion, psychosocial support and referrals into nurse\u2010led mobile SRH clinics that also provided HIV testing, and status\u2010neutral ART and oral PrEP. Standard of care was PrEP delivered through primary health clinics. We report SRH service uptake from the 20 intervention clusters during the first period of the SWT (NCT05405582).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between June 2022 and September 2023, peer\u2010navigators reached 9742 (74.9%) of the 13,000 youth in the target population, 46.8% males. Among 9576 individuals with needs assessment, peer\u2010navigators identified 141 (1.5%) with social needs, and 4138 (43.5%) had medium to high health needs. These individuals were referred to mobile clinics, with 2269 (54.8%) attending, including 959 (42.3%) males. HIV testing uptake was high (92.7%; 2103\/2269), with 10.1% (212\/2103) testing positive for HIV, 62 (29.2%) of whom started ART for the first time. The prevalence of HIV was higher among females compared to males (15.1% vs. 3.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Among clinic attendees, 96.8% were screened for PrEP eligibility, with 38.5% deemed eligible and offered PrEP. Of the 1433 (63.2%) individuals tested for sexually transmitted infections (STIs), 418 (29.2%) tested positive, with females having higher STI prevalence (37.2% vs. 17.9%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Of these, 385 (92.1%) received STI treatment. Among 1310 females, 769 (58.7%) reported not using any contraception at their initial visit, and 275\/769 (35.8%) started contraception during the trial.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Community\u2010based and person\u2010centred approaches delivered through trained peer\u2010navigators can link AYA with SRH and HIV prevention\/care needs with mobile SRH services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.70032","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:20:35Z","timestamp":1759918835000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Person\u2010centred HIV care and prevention for youth in rural South Africa: preliminary implementation findings from\n                    <i>Thetha Nami ngithethe nawe<\/i>\n                    stepped\u2010wedge trial of peer\u2010navigator mobilization into mobile sexual health services"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3278-1847","authenticated-orcid":false,"given":"Jacob","family":"Busang","sequence":"first","affiliation":[{"name":"Africa Health Research Institute  Mtubatuba South Africa"},{"name":"Institute for Global Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nqobile","family":"Ngoma","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute  Mtubatuba South Africa"},{"name":"Institute for Global Health University College London  London UK"},{"name":"School of Medicine Faculty of Health Sciences University of Pretoria  Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thembelihle","family":"Zuma","sequence":"additional","affiliation":[{"name":"Africa Health 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