Development and pilot testing of an empowerment-based intervention for adolescents and young adults living with HIV transitioning to adult HIV care in Uganda

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Background: Transition from adolescent to adult HIV care is a vulnerable period for adolescents and young people living with HIV (AYLHIV). It is marked by increasing responsibility for health management alongside ongoing psychosocial, developmental, and structural challenges. Many AYLHIV report limited preparation for adult care. Existing transition interventions often prioritize biomedical outcomes and are developed in high-income settings, with less emphasis on empowerment and contextual relevance in low- and middle-income countries. This study aimed to develop and assess the feasibility and acceptability of an empowerment-focused intervention to support AYLHIV during transition to adult HIV care. Methods: We developed the Empowerment and Personal Transformation (EPT) intervention, a six-module psychosocial program designed to address communication, self-management, emotional regulation, and personal growth during transition. Intervention content was informed by qualitative data collected through in-depth interviews with AYLHIV and key stakeholders during the intervention development phase. The intervention was subsequently implemented, and feasibility and acceptability were assessed using quantitative measures. Internal consistency of feasibility and acceptability scales was evaluated using Cronbach's alpha coefficients. Results: The EPT intervention demonstrated high feasibility and acceptability among participants. The intervention was perceived as practical to deliver, not burdensome, and responsive to participants' transition-related experiences. Acceptability findings indicated strong participant engagement and approval, with participants describing the intervention as relevant to their psychosocial needs, including experiences of stigma and challenges related to transitioning to independent HIV care. The acceptability subscale demonstrated excellent internal reliability (Cronbach's alpha = 0.92), while the feasibility subscale showed good internal consistency (Cronbach's alpha = 0.86). Conclusions: Findings suggest that empowerment-focused interventions are feasible and acceptable for supporting AYLHIV transitioning to adult HIV care.

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