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Using statewide HIV surveillance and administrative data, we conducted a retrospective cohort study of 493 YLWH in South Carolina (SC) who transitioned to adult care between 2005 and 2021. Retention in adult care was defined as \u2265\u20092 viral load or CD4 tests at least 6 months apart within one year of the first adult visit, and viral suppression as a last recorded viral load\u2009&lt;\u2009200 copies\/mL within one year. Multivariable logistic regression assessed individual- and county-level factors associated with retention in adult care and viral suppression, respectively. Overall, 52.7% of YLWH were retained in care and 49.1% achieved viral suppression one-year post-transition. Younger transition age and lower pre-transition CD4 count (\u2264\u2009200 cells\/mm\u00b3) were associated with higher odds of retention in adult care, while higher pre-transition viral load (&gt;\u2009200 copies\/mL), men who have sex with men\/injecting drug use, heterosexual transmission, and higher socioeconomic vulnerability were associated with lower retention. For viral suppression, Black race, heterosexual transmission, and lower pre-transition CD4 counts were significantly associated with reduced odds of viral suppression. Post-transition outcomes among YLWH in SC remain suboptimal, highlighting the need for targeted, multilevel interventions addressing immunologic vulnerability and socioeconomic disadvantage in the Southern U.S.<\/jats:p>","DOI":"10.1007\/s10461-026-05174-7","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T20:03:09Z","timestamp":1779739389000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-transition Care Retention and Viral Suppression Outcomes Among Youth Living with HIV in South Carolina: A Real-World Data Research"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5477-0906","authenticated-orcid":false,"given":"Hao","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiyi","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanghui","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoming","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bankole","family":"Olatosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Weissman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Widener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueying","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"5174_CR1","unstructured":"Kalapila AGS, David H. 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