In sub-Saharan Africa (SSA), the aging of HIV-positive pediatric cohorts and growing numbers of adolescents on treatment, coupled with high HIV incidence in this age group, means the number of adolescents living with HIV (ALHIV) will continue to grow. The clinical, psychological, social, and reproductive health needs of ALHIV remain poorly understood and efforts to mobilize and advocate for their treatment, care, and support have been inadequate. A multi-country assessment of the needs of ALHIV in SSA found that comprehensive, adolescent-friendly services that champion peer support and collaboration between health care organizations can foster successful transitions into adulthood for ALHIV.