Peer support and psychosocial gains among adolescents living with HIV: Mixed methods evaluation of an overnight camp in Uganda

• Mixed methods study assessed camp effects on HIV viral loads in Ugandan adolescents. • No significant viral load differences found between campers and non-campers. • Camp fostered peer support and shared identity among adolescents with HIV/AIDS. • Group medication rituals and healthcare supervision promoted adherence behaviors. • Psychosocial benefits may influence adherence through non-clinical pathways. This mixed methods study evaluated the effects of Sanyuka Camp, an overnight camp program in Uganda, on HIV viral loads and ART adherence behaviors among adolescents living with HIV (ALHIV). The quantitative component compared viral loads of camp participants ( n = 41–49 annually) with a control group ( n = 48–64 annually) over five years (2016–2020), examining measurements before, three months after, and twelve months after camp. The qualitative component, conducted in 2023, gathered data through focus groups with 33 ALHIV (ages 14–18) and interviews with five camp leaders. Although no statistically significant differences in viral loads emerged among camp attendees and non-attendees, qualitative findings revealed positive camp experiences including peer connections with shared identity, supportive relationships with healthcare workers, enhanced understanding of ART adherence, and specific camp activities that promoted medication adherence behaviors. Participants particularly valued taking medications as a group, supervised medicine administration, and interactive educational activities. Challenges included pre-camp apprehension, concerns about HIV disclosure through branded items, and disappointment when returning to less supportive home environments. Although the camp intervention did not directly influence suppression of viral loads, it provided meaningful psychosocial benefits and educational opportunities that could support long-term health behaviors among ALHIV beyond clinical measures of viral suppression.