Adolescents and young adults are often highlighted as the groups facing the greatest challenges living with HIV and the poorest treatment outcomes. They represent a combination of those who have grown up with HIV, and those who have acquired HIV as young people - often as members of young key populations. If they are successfully linked to and retained in care, they will eventually be the people who live the longest with HIV and take ART the longest. Solutions to improving engagement in care, adherence, and retention need to come from young people themselves if we are to have any chance of ensuring youth thrive.