Table 5.

Qualitative Findings Summary.

Theme	Sub theme	Example quote (s)
Skills from SP training that HCWs were using in practice	Patient-centered communication	“The other thing is that adolescents are the kind of people you have to establish a relationship with before handling them. Otherwise, you might miss everything. Actually, it (SP training) made me know how to handle the adolescents’ right from welcoming them in the facility, the kind of question and how I should structure them in order to get information from them. Otherwise, if you go your own way then you might not get anything from the adolescents.” Counselor, Trained 2018
	Systematic clinical evaluation of ALHIV	“It (SPEED Training) has improved my counseling skills, how to motivate them to open up, and probing skills and I am able to do a detailed clinical assessment for the adolescents than before.” Clinician, Trained 2017
Impact of the SP training on HCW's attitudes towards ALHIV		“You see now, before I attended that training you see the youths were very shy and more so to those questions which we ask them but then after the training I had to develop strategies whereby I can now engage an adolescent or a youth without that youth feeling offended or rather initially I used to be judgmental towards the adolescents and the youth, since then… and more so there are those questions which you can ask an adolescent you find that they don‘t want to open up.” Counselor, Trained 2017
Durability of skills 12 months after the training.	Facilitators and barriers to using skills in routine care	“I can say that all the objectives that were in SPEED training were relatively linked to my day-to-day work, so I have to apply everything that I learned in my day-to-day work. I can say that I had to do what I learnt in the interaction with the adolescents. Therefore, I do not think there is anything that will hinder me or rather stop me from using the skills that I acquired.” Counselor, Trained 2018 “One thing we have a specific day for adolescents so that day we specifically …it is for adolescents so one thing …they are in the same age group so if there is a client who has an issue with confidentiality or disclosure and doesn‘t what to be seen with other clients will feel at least comfortable and in that forum.” Clinician, Trained 2017
	Perceived impact of training	“Through the motivational interviewing I can say that … there has been a change in everything. In self-esteem, retention because I have actually not lost any adolescent since I started engaging them one on one when I started, I had almost talked to all of them now I started engaging them as a group, yeah, and they look forward to coming to the clinics, even on different sessions. So, I feel that it has impacted their lives.” Clinician, Trained 2018