"Now, I have no fear": aqualitative assessment of the interactive transition support for adolescents living with HIV in South Africa virtual vs. in-person (inTSHA VIP) intervention.

South Africa has the highest number of adolescents living with HIV (AHIV) globally, many of whom face disengagement and virologic failure when transitioning from pediatric to adult care. Using the Social-ecological Model of Adolescent and Young Adult Readiness to Transition (SMART) and the Technology Acceptance Model (TAM), we evaluated the acceptability, feasibility, and perceived effectiveness of an in-person and virtual adolescent support intervention (InTSHA VIP). We conducted eight focus groups with 41 AHIV aged 15-19 who received the intervention (mean age: 18.5 years, 70.1% female) and 20 in-depth interviews with youth-facing healthcare workers (HCWs) at participating clinics (mean age 43.3 years). Transcripts were coded and thematically analyzed, framed by SMART and TAM. Participants reported improved knowledge, self-efficacy, psychosocial wellness, and relationships with family and HCWs. HCWs perceived InTSHA VIP as highly useful for improving retention in care and viral suppression. Barriers included technology challenges, scheduling conflicts, and transportation access. Future implementation should address structural barriers to access while leveraging the intervention's adaptability to optimize impact and sustainability.