Globally, as of 2021, the number of people living with human immunodeficiency virus (HIV) was estimated at 38.4 million, with 1.7 million being children aged 0 to 14 years [1]. Within the Sustainable Development Goals (SDGs), Goal 3 focuses on ensuring healthy lives and promoting well-being for all at every stage of life, including targeting an end to the AIDS epidemic by 2030. This goal encompasses reducing new HIV infections, ensuring universal access to prevention, treatment, care, and support services for HIV, and achieving viral suppression for individuals living with the virus [2]. In 2021, 85% of people living with HIV globally knew their status, 75% were accessing treatment, and 68% had achieved a low viral load [1]. However, these achievements vary significantly across different population groups, with adolescents in sub-Saharan Africa (SSA) notably falling behind in viral load suppression (VLS) [1]. The World Health Organization (WHO) defines adolescents as individuals aged 10 to 19 years [3].

In SSA, three in every four new HIV infections are young people, and six in every seven new infections among adolescents aged 15–19 years were among women, accounting for 63% of all new HIV infections [1]. Adolescents in SSA continue to be disproportionately affected, contributing the most significant part of the overall HIV suppression failure prevalence of 47% [4]. Information, especially regarding the prevalence of VLS among adolescents (10–19 years) living with HIV on ART, remains scarce in Tanzania.

Viral load suppression is a crucial marker of therapy efficacy in PLHIV. To be termed that the virus is suppressed, the VLS is thought to be < 1000 copies/ml of plasma and unsuppressed when ≥ 1000 copies/ml of plasma [5]. The fundamental goal of HIV infection treatment is to suppress HIV, which will ultimately increase survival, improve quality of life, and reduce HIV transmission [5]. In addition, follow-up of the VLS status among adolescents is crucial for early identification of treatment failure for patients needing intensive adherence counselling and prevents the occurrence of drug resistance [6]. Therefore, UNAIDS launched the 95–95–95 targets in 2014, the “Third 95” target aiming to increase viral load suppression to 95% of all HIV-infected individuals on ART by 2030 [4]. The “Third 95” target focused on defeating HIV/AIDS because HIV patients with VLS have low chances of transmitting infections to others [4].

Several efforts have been undertaken to address the issue of viral non-suppression among people living with HIV (PLHIV) in Tanzania. These efforts encompass enhanced treatment adherence programs offering education, counseling, and support services, alongside increased availability and accessibility of viral load (VL) testing services to monitor antiretroviral therapy (ART) effectiveness and detect non-suppression early. Healthcare providers have been provided with training on the importance of VL monitoring, result interpretation, and appropriate actions in case of non-suppression. Additionally, newer, more potent ART medications like DTGs are being promoted, while communities affected by HIV/AIDS are being engaged to raise awareness about the importance of ART adherence. Advocacy for policies supporting comprehensive HIV/AIDS care and treatment, including strategies to improve viral load suppression rates, is also ongoing [7,8,9,10].

In Tanzania, among people living with HIV (PLHIV) aged 15 years and older who are receiving antiretroviral therapy (ART), only 37.9% achieved viral load suppression (VLS) among adolescents and young adults aged 15–24 years [9]. Despite the concerning treatment outcomes regarding VLS among adolescents receiving ART in Tanzania, their circumstances are often overlooked. This oversight may stem from how age is categorized in Tanzania, where adolescents between 10 and 14 years are grouped with children aged 0–14, while those between 15 and 19 years are considered adults [9, 10]. This classification system limits the availability of specific HIV treatment outcome data for adolescents aged 10–19 years. Furthermore, while adolescents constitute a significant proportion of individuals with virally non-suppressed HIV in Tanzania, there is limited published data on treatment outcomes for adolescents aged 10 -19 years regarding VLS and associated factors.

Adolescents are in the transition phase from childhood to adulthood, so the physiological changes resulting from puberty put them at different risks, including behavioural changes that might interrupt ART adherence and delay achieving the “Third 95” target. Lack of special attention to this population segment puts them at high risk of HIV-related morbidity and mortality. Understanding HIV treatment outcomes for adolescents (10–19 years) and associated factors is critical to urgently identify and inform program interventions to optimize ART outcomes to help achieve the “Third 95” target of suppressing viral load to 95%.