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A growing body of evidence suggests that improving the mental wellness of adolescents living with HIV (ALHIV) will also result in improved adherence to antiretroviral therapy (ART), as well as improving their general health and wellbeing as they age into adulthood. However, to develop effective strategies and interventions aimed at improving mental wellness, we require age and culturally appropriate instruments to build an evidence base. Currently, there is a lack of mental wellness measures developed for ALHIV, especially in the African context. To address this gap, we developed a measure of mental wellness following modified guidelines set out by DeVellis and Godfred et al. as a guiding framework ; (1) Identifying the gap, (2) Set the theoretical foundations and identify domains and (3); Instrument development and initial validation. For the first two steps, we conducted a systematic review, photovoice study …