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We have few in-depth, qualitative understandings of engagement with HIV care from AYAH's perspectives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted semistructured, in-depth interviews with 113 AYAH during a 2-year multilevel intervention to improve viral suppression and health outcomes in rural Kenya and Uganda. Youth participants were purposively sampled and balanced for sex, life stage, and HIV care status to achieve heterogeneity of the characteristics thought to influence the pathways of action and challenges to sustaining HIV care retention. Thematic analysis explored how youth themselves perceived factors that facilitated or challenged clinic attendance and HIV care retention, with the aim of uncovering any distinctions they made within these categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Findings revealed a youth-defined concept of HIV care that includes intrinsic social components such as familial support, examples of living positively, a sense of maturing as part of a community, and respectful providers. Youth implicitly distinguished between simply keeping appointments (\u201cretention in care\u201d) and caring about oneself with a shared commitment to health in conjunction with their family and providers (\u201cengagement in care\u201d).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We argue for differentiating \u201cretention in care\u201d and \u201dengagement in care\u201d along lines similar to distinctions between disease (biomedical definition), illness (personal experience), and sickness (social dimension).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259582261457320","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T11:50:48Z","timestamp":1781869848000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Retaining Versus Engaging Youth in HIV Care: Perspectives From a Qualitative Study among Youth Living With HIV and Their Care Providers in Kenya and Uganda"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9561-6366","authenticated-orcid":false,"given":"Jason","family":"Johnson-Peretz","sequence":"first","affiliation":[{"name":"Department of Medicine, University of California, San Francisco (UCSF)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angeline","family":"Onyango","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute (KEMRI)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Akatukwasa","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrick","family":"Atwine","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Owino","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute (KEMRI)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilyn","family":"Nyabuti","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute (KEMRI)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice","family":"Litunya","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute (KEMRI)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Kabami","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Bukusi","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California, San Francisco (UCSF)"},{"name":"Kenya Medical Research Institute (KEMRI)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9467-0950","authenticated-orcid":false,"given":"Florence","family":"Mwangwa","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses R.","family":"Kamya","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Collaboration (IDRC)"},{"name":"Makerere University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane V.","family":"Havlir","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California, San Francisco (UCSF)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Ayieko","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute (KEMRI)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore","family":"Ruel","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California, San Francisco (UCSF)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol S.","family":"Camlin","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California, San Francisco (UCSF)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003651"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-019-02568-8"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2010.0086"},{"key":"e_1_3_3_5_2","unstructured":"HIV.gov. 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