"Since I got the education, I feel like a kind of warrior": a qualitative study of participant perspectives and preferences about Sauti ya Vijana, a mental health intervention for young people with HIV in Tanzania.

Adolescents and young adults with HIV (AYAWH) face challenges with medication adherence and are at risk of mental health (MH) difficulties. Sauti ya Vijana (SYV, The Voice of Youth) is a co-created, peer-led, group-based MH intervention designed to address these needs. This study aimed to: (1) evaluate how participation in SYV impacted AYAWH's lives in Tanzania and (2) explore AYAWH perspectives and preferences of the intervention. The SYV trial was conducted across four regions of Tanzania. Trial participants randomized to the intervention arm were purposefully recruited for focus group discussions (FGDs), with two waves conducted shortly post-intervention and two waves approximately 12-months post-intervention. FGDs were thematically analyzed using a hybrid inductive-deductive approach informed by the socio-ecological framework. AYAWH (N = 208) participated in 32 FGDs averaging 80 minutes. Prominent personal themes included the importance of HIV and MH knowledge which participants perceived to improve their medication adherence, coping, and self-confidence. Familial and interpersonal themes included sharing personal information that strengthened relationships, empowered onward disclosure and knowledge-sharing. Systemic themes included hope for the future due to a sense of worth and belonging in the community. SYV participants suggested that the program was largely beneficial and should be scaled to support more youth.