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After 2 years of living with COVID\u201019, it is important to examine the direct and indirect effects of the pandemic on healthcare resources, access to HIV services and availability of support structures, to assess their impact on HIV care for ALHIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The COVID\u201019 response in South Africa has shifted healthcare resources towards combatting COVID\u201019, affecting the quality and availability of HIV services\u2014especially for vulnerable populations, such as ALHIV. The healthcare system's response to COVID\u201019 has threatened to diminish fragile gains in engaging ALHIV with HIV services, especially as this group relies on overburdened public health facilities for their HIV care. Reallocation of limited health resources utilized by ALHIV disrupted healthcare workers\u2019 capacity to form and maintain therapeutic relationships with ALHIV and monitor ALHIV for ART\u2010related side effects, treatment difficulties and mental health conditions, affecting their ability to retain ALHIV in HIV care. Prevailing declines in HIV surveillance meant missed opportunities to identify and manage opportunistic infections and HIV disease progression in adolescents. \u201cLockdown\u201d restrictions have limited access to healthcare facilities and healthcare workers for ALHIV by reducing clinic appointments and limiting individual movement. ALHIV have had restricted access to social, psychological and educational support structures, including national feeding schemes. This limited access, coupled with reduced opportunities for routine maternal and sexual and reproductive health services, may place adolescent girls at greater risk of transactional sex, child marriages, unintended pregnancy and mother\u2010to\u2010child HIV transmission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adolescent HIV care in South Africa is often overlooked; however, ART adherence among ALHIV in South Africa is particularly susceptible to the consequences of a world transformed by COVID\u201019. The current structures in place to support HIV testing, ART initiation and adherence have been reshaped by disruptions to health structures, new barriers to access health services and the limited available education and psychosocial support systems. Reflecting on these limitations can drive considerations for minimizing these barriers and retaining ALHIV in HIV care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25904","type":"journal-article","created":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T01:51:17Z","timestamp":1651024277000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Two years after lockdown: reviewing the effects of COVID\u201019 on health services and support for adolescents living with HIV in South Africa"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5004-2490","authenticated-orcid":false,"given":"Quintin","family":"van Staden","sequence":"first","affiliation":[{"name":"Department of Sociology University of Cape Town  Cape Town South Africa"},{"name":"Universitas Hospital  Bloemfontein South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9648-4473","authenticated-orcid":false,"given":"Christina A.","family":"Laurenzi","sequence":"additional","affiliation":[{"name":"Institute for Life Course Health Research Department of Global Health Faculty of Medicine and Health Sciences Stellenbosch University  Tygerberg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3800-3173","authenticated-orcid":false,"given":"Elona","family":"Toska","sequence":"additional","affiliation":[{"name":"Department of Sociology University of Cape Town  Cape Town South Africa"},{"name":"Centre for Social Science Research University of Cape Town  Cape Town South Africa"},{"name":"Department of Social Policy and Intervention University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,4,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-10296-9"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-020-03005-x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2020.09.039"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2015-000004"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-020-02960-9"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000183129.16830.06"},{"key":"e_1_2_9_8_1","unstructured":"SimbayiL ZumaK ZunguN MoyoS MarindaE JoosteS et\u00a0al.South African National HIV Prevalence Incidence Behaviour and Communication Survey.2019."},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(19)30234-6"},{"issue":"3","key":"e_1_2_9_10_1","first-page":"4","article-title":"Living and dying to be counted: what we know about the epidemiology of the global adolescent HIV epidemic","volume":"20","author":"Slogrove AL","year":"2017","journal-title":"J Int AIDS Soc"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/4161738"},{"key":"e_1_2_9_12_1","unstructured":"SouthAfrican National AIDS Council. 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