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Review
. 2025 Dec 2:S2352-3018(25)00271-1.
doi: 10.1016/S2352-3018(25)00271-1. Online ahead of print.

Enhancing HIV prevention through systematic community engagement, learning, and response

Ima John-Dada  1 , Lilian Otiso  2 , Stephen Ayisi Addo  3 , Grace Kumwenda  4 , Raymond Yekeye  5 , Stephen N Kiio  6 , Chimwemwe Mablekisi  7 , Chimika Phiri  8 , Florence R Anam  9 , Nina S Hasen  10 , Barinaada Afirima  7 , Lillian Mworeko  11 , Anne-Isabelle Cameron  12 , Simon Sikwese  13 , Prosper F Njau  14 , Yohane Kamgwira  7 , Sarah N Konopka  15 , Thato Farirai  16 , Richard Chilongosi  17 , Rosemary Mburu  18 , James Odek  19 , Alister Munthali  20 , Gaetan Gatete  21 , Nyanyiwe M Mbeye  22 , Gisele Mujawamariya  21 , Nellie Bristol  23 , Sarah Mwale  24 , Sara M Allinder  19 , Betha O Igbinosun  19 , Charles B Holmes  19 , Solange L Baptiste  25
Affiliations
Review

Enhancing HIV prevention through systematic community engagement, learning, and response

Ima John-Dada et al. Lancet HIV. .

Abstract

Successful uptake of existing and new HIV prevention interventions demands meaningful, systematic, and participatory engagement integrated across the conception, design, implementation, and assessment phases of programming. Despite proven impact of community engagement, it remains chronically underfunded and is often not conducted consistently or as part of harmonised national policy and practice, causing gaps that are likely to worsen in the current funding environment. Systematic models of community engagement-from peer-led outreaches to community-led monitoring and advisory boards-strengthen trust, responsiveness, and accountability. Equally crucial are mechanisms for harmonising and incorporating community insights into the design and implementation of new prevention tools, and using these insights to inform more responsive programmes and policies. Harnessing benefits of community engagement requires increased resource allocation; clear policy frameworks with measurable performance indicators; leadership opportunities for community members, especially youth and key populations; and the use of innovative technologies to expand the reach and impact of interventions. Only with concerted and inclusive community engagement backed by resources and political commitment will HIV prevention efforts elicit the trust and buy-in needed to sustainably manage the HIV pandemic over the long term.

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Conflict of interest statement

Declaration of interests SLB has received support from the Gates Foundation to attend the Banbury Center meeting on AI and HIV Programs in Africa (November, 2024); is a board member of the AIDS Vaccine Advocacy Coalition; is a member of the steering committee of the Global Fund Advocates Network; and is the Executive Director of the International Treatment Preparedness Coalition, which is the fiscal host of the Global Public Investment Network and Global Coalition of TB Activists. NB has received funding support from Georgetown University; and holds contracts with Duke University, Brown University, and the Center for Strategic and International Studies. GG has received honoraria payments from Georgetown University. GK has received travel and accommodation support from Georgetown University to attend the Sustainable HIV Prevention Meeting in Lilongwe, Malawi (February, 2025). CBH has received a grant from the Gates Foundation to the Center for Innovation in Global Health at Georgetown University for the Blantyre Prevention Strategy (INV-002606); has received a grant from the Gates Foundation to the Center for Innovation in Global Health for the Sustainable Prevention Initiative (INV-064383); has received consulting fees from the Gates Medical Research Institute; and holds a position on the board of directors for the Center for Infectious Diseases Research in Zambia. SMA has received funding support from the Gates Foundation for the Blantyre Prevention Strategy (INV-002606); has received consulting fees and grants from Pharos Global Health Advisors; has received payment and honoraria from FHI 360 as a member of the MOSAIC project's product access advisory committee; and has participated on a data safety monitoring and advisory board for the MOSAIC project's product access advisory committee. BOI has received grants from the Gates Foundation to the Georgetown University Center for Innovation in Global Health for BPS (INV-002606) and the Sustainable Prevention Initiative (INV-064383). All other authors declare no competing interests.

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