Abstract
Adolescents living with HIV (ALHIV) experience several psychosocial challenges, including stigma,
isolation, and mental health difficulties, which can negatively impact treatment adherence. In Botswana,
there is a need for further exploration of adolescent-friendly psychosocial interventions to support ALHIV
with adherence challenges. This study used qualitative methods to explore a pilot group art therapy
intervention for adolescents struggling with adherence at an HIV care facility in Gaborone, Botswana. A
five-session group art therapy intervention was implemented with adolescents aged 15-19. Through thematic
analysis of the data, four overarching themes were generated: Solitary Coping and Self-Reliance: Strengths
and Unmet Relational Needs; Connection as Desired and Valued; Discomfort, Stigma and the Difficulty of
Seeking Support; and the Importance of Agency, Limits to Claiming it, and Group Art Therapy as an
Agentic Space. The findings highlight the importance of social connection, relational safety, and
opportunities for exercising agency for ALHIV. The study suggests that group art therapy may be a
meaningful approach to supporting ALIV by facilitating social connection, peer support, and increased selfconfidence.