Factors affecting adolescent participation in HIV/AIDS prevention services provided by Non-Governmental Organizations in Iran

Abstract

One of the best ways to reach teenagers with high-risk behaviors and encourage them to use HIV/AIDS prevention services is to seek help from non-governmental organizations (NGOs). Therefore, in Iran, some NGOs active in this field were formed under the name of Adolescent Well-being Clubs. One of the key strategies of these centers has been to attract the effective participation of teenagers. This study intended to identify the factors affecting adolescents’ participation in the HIV/AIDS prevention services provided by NGOs using the experiences of Adolescent Well-being Clubs. In this study, we chose an interpretive/constructivist paradigm and a descriptive qualitative approach. Four focus group discussions (with 26 teenagers) and 17 in-depth interviews were conducted to collect qualitative data between October and December 2020. Participants were 36 adolescents with high-risk behaviors and 7 adolescent well-being club managers. Purposeful sampling methods for adolescents and census-based for managers were used. Data was collected for participants living in Tehran in person at the adolescent well-being clubs and for participants from other cities online using Skype. Conventional content analysis was applied. Four major themes were extracted that affect the participation of teenagers in HIV/AIDS preventive services provided by NGOs: individual and structural factors (adolescents’ development and challenges, access to health and social services), social factors (social stigma and discrimination), and organizational factors (trust and collaboration, engagement and participation, quality of services and environment, understanding and respect for adolescents). This study reveals that adolescent participation in HIV/AIDS prevention services is shaped by a complex interplay of individual/structural challenges, social influences, and organizational dynamics. Empowering adolescents through active involvement in program design and decision-making can enhance service utilization. These findings underscore the importance of culturally sensitive, inclusive, and trust-based strategies—particularly those led by NGOs—for ensuring sustainable HIV/AIDS prevention among high-risk adolescent populations.