Achieving better engagement with care and support for young people living with HIV in Australia: a mixed-method enquiry.

Young people aged 18-29 are considered "adult" within the Australian HIV health service context. However, evidence increasingly defines this age group as distinct from the broader adult population such that the needs of young people living with HIV may be overlooked in the context of HIV service design and delivery. This analysis draws on the Young + Positive study, a national study in Australia that documented the perspectives of young people (aged 18-29) living with HIV. Data were collected via survey (n = 60) and interview (n = 25) methods between 2018 and 2019. The data were analysed using descriptive statistics and thematic analysis, exploring the inner- and outer-world factors influencing participant engagement with HIV care and support. Using the multi-dimensional framework by Harms [2021. Understanding human development (3rd ed.). Oxford University Press], we found that both inner- and outer-world factors influenced participants' ability and motivations to engage with specialist HIV treatment and support. Inner-world factors included psychological outlook, and perceptions of HIV and HIV services. Outer-world factors included workforce competencies of service providers, physical space of the service and hours of service operation. These research findings confirm that opportunities exist to better meet the treatment and care needs of young people living with HIV.