Young people are high risk of HIV infection and have disproportionately poorer outcomes across the HIV care cascade compared to other age-groups. Existing programmes have been relatively unsuccessful in engaging young people and their access to key health services remains limited. The symposium will present the findings of a pragmatic cluster randomised trial (CHIEDZA) evaluating an innovative community-based package incorporating HIV testing, treatment and follow-up care, adherence support and HIV prevention, with integrated comprehensive sexual and reproductive health (SRH) services (including aetiological management of sexually transmitted infections) for youth. The trial was conducted across Zimbabwe and outcomes (aligned to UNAIDS 90-90-90 targets) were measured at population level. A process and cost evaluation will be presented highlighting on-the-ground lessons learnt on integrating HIV and SRH services-critical to inform programming. Innovative youth and community engagement approaches and ethical issues such as post-trial access will be discussed.