Longitudinal Findings From a Land-Based HIV Prevention Study With Northern and Indigenous Youth, Canada

The high prevalence of sexually transmitted infections (STIs) in the Northwest Territories (NWT), Canada underscores the need for culturally relevant, community-driven sexual health initiatives for HIV and STI prevention that prioritize youth engagement and Indigenous leadership. FOXY (Fostering Open eXpression among Youth), a Northern and Indigenous NWT-based community-based organization, conducted 1-week youth Peer Leader Retreats (PLRs) focused on HIV prevention and leadership using land- and arts-based approaches. We conducted a one-group pretest/posttest with youth PLR participants aged 13 to 17 in the NWT and combined the data across PLRs conducted from 2020 to 2022. Assessments were completed at preretreat baseline, immediately postretreat, and at 6-month follow-up to measure changes in study outcomes (safer sex self-efficacy [SSSE], condom use self-efficacy [CUSE], and HIV knowledge). Of <i>n</i> = 133 participants at baseline, 6-month follow-up data were available for n = 122 (92%) participants. Multivariate analyses showed significant improvements in all study outcomes from baseline to 6-month follow-up. SSSE, CUSE, and HIV knowledge scores increased postretreat and continued to improve at 6 months. These findings suggest that culturally relevant, community-driven peer leadership interventions hold promise in advancing HIV prevention cascade outcomes with Northern and Indigenous youth in the NWT.