Abstract
BACKGROUND: HIV-related stigma interventions targeting adolescents living with HIV (ALHIV) are limited. When available, most of these interventions operate at a single socioecological level and target a single stigma domain, and participatory design is rare. OBJECTIVE: This study aimed to explore the psychosocial support intervention needs of ALHIV from the perspectives of adolescents, caregivers, and healthcare providers, and to develop a digital anti-HIV-related stigma intervention. METHODS: A formative qualitative design with 27 in-depth interviews was conducted in three hospitals that provide an in-clinic psychosocial support to ALHIV in southern Ethiopia. Audio-recorded interviews were transcribed verbatim, translated, and analysed using NVivo 14.0. Codes emerged from the data, leading to the development of categories and subcategories through qualitative content analysis. RESULTS: The results are presented in three categories: coping with today, lowering barriers through knowledge and education, and worrying about future relationship. Fear of rejection and lack of trust led ALHIV to keep their status secret. Although adolescents were optimistic about their future in areas like education, achieving goals, and employment, they worried about forming relationships. Peer support groups offered valuable experiential support but struggled with geographical and logistical barriers. Digital tools emerged as a promising solution to overcome these barriers and enhance peer support group networking. CONCLUSION: Addressing nondisclosure reasons, such as fear of rejection and lack of emotional preparedness, and enhancing supportive networks can empower adolescents and strengthen their resilience. Their willingness to disclose and educate others can lay the groundwork for creating a stigma-free environment.