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

Background: Transition from adolescent to adult HIV care is a critical period for adolescents and young people living with HIV (AYLHIV), marked by increasing responsibility for self-management alongside ongoing psychosocial and developmental challenges. Existing transition interventions have largely focused on biomedical outcomes and have primarily been developed in high-income settings, with limited attention to empowerment and contextual relevance in low- and middle-income countries. This study aimed to develop and assess the feasibility and acceptability of the Empowerment and Personal Transformation (EPT) intervention to support AYLHIV during transition to adult HIV care. Methods: The EPT intervention was developed using qualitative data from in-depth interviews with AYLHIV, caregivers, and healthcare providers, informed by Empowerment Theory and Social Cognitive Theory. The final intervention comprised six modules addressing communication, empowerment, self-regulation, self-concept, resilience, self-management, and emotional processing. The intervention was subsequently implemented among 40 AYLHIV, and feasibility and acceptability were assessed among the 37 participants who completed the intervention using the Feasibility of Intervention Measure and the Acceptability of Intervention Measure. Internal consistency was assessed using Cronbach alpha coefficients. Results: Qualitative findings identified key needs related to communication, confidence, stigma, emotional wellbeing, resilience, self-management, and transition readiness, which informed intervention development. The final EPT intervention integrated psychoeducation, skills building, reflection, peer learning, and experiential activities. The intervention demonstrated high feasibility and acceptability. Mean feasibility and acceptability scores were 18.37 (SD = 2.10) and 18.51 (SD = 2.02), respectively, out of a maximum score of 20. Internal consistency was high for both feasibility ( = 0.86) and acceptability ( = 0.92). More than 94% of participants agreed or strongly agreed that the intervention was feasible, acceptable, and relevant to their needs. Conclusions: The EPT intervention was feasible and acceptable among AYLHIV and addressed psychosocial and behavioral needs identified during transition to adult HIV care. These findings support further evaluation of the intervention's effectiveness in improving transition-related and HIV care outcomes.