I originally came to Tanzania working on a research project regarding prevention of mother-to-child transmission of HIV, which has been a real success story in the HIV epidemic. However, in the adolescent clinic, it’s been quite a different story. In all demographics, mortality is reduced, with the exception of youth 10 to 19, for which mortality actually rose by 50%. We know how to diagnose HIV. We know how to treat HIV. So there really isn’t much of an excuse from a medical standpoint of why these youth are dying of HIV, except behaviors. So we needed to really understand what was preventing them from taking their medicine. You might find a youth gets medicine, and you may find that youth attend the clinic, but youth lack some of the strategies. They don’t really think positive things. What they think is they’re going to die. What they think is they’re going to not be like other people. What we found in our research was that in one cohort, mental health difficulties were around 25%, and in another cohort, they were upwards of 50%. And that these mental health difficulties, such as depression and traumatic symptoms, were highly associated with poor adherence. Some of them, they have denial and fear about their diseases and some of them, they are afraid about the medications’ side effects, and sometimes they have misconceptions and misinformation about the drugs or about the disease. And they also, youth or adolescents, some of them, still they have stigma and discrimination. It means they’re ignored or discriminated by their family or relatives. Addressing these mental health difficulties in youth was quite a new area. We were embarking on a new journey. There were very few mental health specialists. There were no clinical psychologists. So we developed an intervention utilizing lay counselors that we chose to be peers, actually, and trained them up to deliver a mental health intervention called “Sauti ya Vijana,” which means “the voice of youth” in English. These peer group leaders are aware of the challenges that HIV-positive adolescents face. They have a unique perspective, so they’re able to communicate effectively, and also create a safe environment where youth feel comfortable bringing up some of the challenges that they have to face in their daily life. The success of the peer-led model in Sauti ya Vijana led us to try a peer-led model in teaching the HIV curriculum that we designed to be implemented in the adolescent HIV clinic. They learn about how to take their medication. They learn about stigma. So they come with awareness of how to take their medication because many of the youth have different questions. So in mental health services, they can get the answers. This intervention was really developed to give them hope for the future, to let them know that they can have a normal life. They can be just as good as their uninfected peer. And that they can go on to have a good job and to have a family, and to have a child that doesn’t have HIV. Many of these youth really weren’t aware of that. That hadn’t been in their dialogue, and that’s not what they were hearing from society. So, allowing youth to be together, to have a safe place to discuss these issues, and to really give them some empowerment and some resilience as they go about their lives was our goal.