HIV-positive youth in Johannesburg villages face unique mental health challenges due to stigma, discrimination, and limited access to support services. Qualitative research methods were employed, including semi-structured interviews with 30 participants aged 15-24 who are HIV positive. Data was analysed through thematic analysis. Findings indicate that while some community-based support groups exist, there is a significant gap in professional mental health services provided by non-governmental organizations (NGOs) and government agencies. The study highlights the urgent need for more comprehensive and accessible mental health support services tailored to HIV-positive youth in Johannesburg villages. Policy makers should prioritise funding for specialized mental health programmes for this population, while NGOs should expand their reach and collaboration with existing organizations. HIV positive youth, mental health support, community-based interventions, stigma, South Africa