Health literacy and adherence to Antiretroviral Therapy among youth living with HIV attending the Care and Treatment Clinic at Temeke Regional Referral Hospital, Tanzania

Background Adherence to Antiretroviral Therapy (ART) remains a public health challenge among youths. Globally, only 65% of adolescents on ART achieve adherence, with 55% attaining viral suppression. In sub-Saharan Africa, youths account for half of new HIV infections. ART adherence is crucial for treatment effectiveness, quality of life, and reducing HIV transmission. This study examined the relationship between health literacy and ART adherence among youths living with HIV attending Care and Treatment Clinic at Temeke Regional Referral Hospital, Tanzania. Methods A cross-sectional study was conducted among 211 youths living with HIV aged 15–24 attending CTC at Temeke Regional Referral Hospital. Participants were systematically sampled from CTC registries. The Health Literacy Questionnaire (HLQ) was used to assess health literacy, and the Medication Adherence Report Scale (MARS-5) was used to assess ART adherence. Data analysis was performed using Stata version 15, including descriptive statistics, bivariable, and multivariable logistic regression. Statistical significance was set at p < 0.05. Results ART adherence was 73.5%. Higher adherence was significantly associated with health literacy domains, including feeling understood and supported by healthcare providers, social support, navigating the healthcare system, active engagement with providers, and accessing reliable health information. Conclusion ART adherence among YLHIV at Temeke RRH CTC remains below WHO and national targets. Strengthening health literacy through reliable health information, supportive provider interactions, and social support networks can enhance adherence. Targeted interventions addressing these factors are essential to improve ART outcomes among youths living with HIV in Tanzania.