In urban Cairo, Egypt, HIV/AIDS prevention programmes often face challenges in reaching youth populations effectively. A mixed-methods approach was employed, including focus group discussions with urban youth, key informant interviews with educators and health workers, and secondary data analysis of existing prevention programme documents. Knowledge sharing mechanisms varied widely among different communities and settings within Cairo. For instance, peer-led workshops reached a significant proportion (40%) of surveyed adolescents in one neighborhood. Although overall effectiveness was noted, disparities existed based on community type and intervention delivery methods. Tailored interventions should incorporate diverse knowledge sharing formats to better engage urban youth across Cairo’s varied neighborhoods.