'I can get all the services I want, without fear of being judged': Acceptability of a sexual and reproductive health service for youth in Zimbabwe.

Sexual and reproductive health (SRH) services often do not appeal to youth, leading to limited engagement and poor outcomes. We co-designed a community-based integrated HIV and SRH service with and for youth (16-24 years) in Zimbabwe (CHIEDZA) and investigated its acceptability. Qualitative data from observations of CHIEDZA services (n = 58), and in-depth interviews with healthcare providers (n = 51), mobilisers (n = 23), and clients (n = 63) were analysed inductively and thematically. Participants who attended CHIEDZA in an endline population-based survey completed a questionnaire assessing their experiences. 96.1% of attendees rated their experience as excellent/very good. Four key features were core to CHIEDZA's acceptability. First, in a context where ordinarily 'condoms and [menstrual] pads are expensive', and clinics charge user fees, free services at CHIEDZA were valued. Second, integrated SRH services was seen as convenient and increased service uptake: 'I came wanting pads, and then also got tested for HIV'. Third, youth-focused 'open-minded' interactions with healthcare providers were central to acceptability. Fourth, a social and safe space for youth was popular. The key reasons for non-attendance was not knowing about CHIEDZA and distance. Youth engagement with SRH services could be enhanced by offering free-of-cost, integrated services and supporting healthcare providers to deliver compassionate and youth-focused care.