Adolescent engagement can enhance research by offering opportunities for empowerment and equity, and increasing relevance. However, to be effective, engagement should uphold ethical principles—particularly for adolescents who are exposed to adversities, including those who become mothers at a young age.

We share five key insights in this paper from our ongoing work with young mothers living with HIV between 16–20 years of age in the Eastern Cape, South Africa, focusing on ethics and methods to maximize engagement. Insights were derived through a series of arts-based activities in participatory workshops with young mothers held in April 2024 and March 2025 (n = 40). First, research with young mothers should respond to evidence gaps about their needs, while also recognizing young mothers as multi-dimensional young people. Second, ethical, equitable engagement from recruitment to closing is paramount; we focus specifically on recruitment and consent processes. Third, research with young mothers should balance between tailoring options towards individuals’ preferences and comfort level, while also structuring types of engagement; arts-based methods can provide a medium for such engagement. Fourth, the format and forum of participant engagement can shape research outputs and experiences, particularly with more sensitive topics and populations. Finally, a working protocol for referrals and follow-ups is essential, and should be easily operationalized, adapted, and updated.

These insights provide context for other researchers engaging with young mothers or other youth facing complex life events in low-resource settings. Ethical practices and participatory methods can support more dynamic knowledge exchange and generate meaningful findings, contributing to more responsive programs and policies.