Background Early HIV testing and treatment is crucial to the survival and long-term well-being of children and adolescents living with HIV. In Sub-Saharan Africa, the risk of HIV transmission and infection among children and adolescents, especially young girls is high. Tanzania adopted the test and treat, where all children and adolescents who tested positive for HIV are initiated into care, though adherence to medication and viral suppression is challenging. Strategies to overcome adherence challenges include education provisions at the clinics. In this study, we assessed the educational content provided, the needs of children and adolescents, and its impact on viral load suppression (VLS).

Methods A cross-sectional study was conducted among 286 children and adolescents living with HIV on ART in Kilimanjaro, Tanzania. Socio-demographic characteristics, clinic educational contents, and viral load results were collected using semi-structured questionnaires. Numerical and categorical variables were summarized using descriptive statistics. We compared the educational contents and adherence with VLS using chi-square tests to find the difference between groups.

Results Among 286 participants recruited: 142 (33.3%) were children and 143 (33.4%) were adolescents. Their median age was 9 (7–12) and 18(16–18), and there were 145 males and 141 females. Among 101 who received education content at the clinics, 68(67%) received education on the importance of taking medication and improving adherence. Of those who received adherence education 48(71%) had VLS while 22(69%) of those who never received adherence education were suppressed(P=0.852). Other 141 children and adolescents reported needing educational seminars at the clinics on adherence, safe sex practices, reproductive health education, and entrepreneurship.

Conclusion Continuous education provision at clinics is vital to improve health and adherence among children and adolescents. Further strategies to incorporate health education in clinics should be implemented even with little evidence of improving VLS from this study.