Abstract
Background This study evaluates the effects of the community-based multi-month dispensing model on adherence to antiretroviral therapy among youth living with HIV in Dodoma City Council. It compares adherence rates between three- and six-month dispensing intervals led by either Community Antiretroviral therapy peers or healthcare workers.Methods This case-control study used data from the CTC2 database to evaluate the effects of community-based multi-month dispensing of antiretroviral therapy. It compares adherence rates between three- and six-month dispensing intervals led by either community antiretroviral therapy peers and those led by health workers. A total of 390 participants participated in the survey. These participants were categorized into two groups: those enrolled in community-based ART multi-month dispensing (case group) and those not in community-based ART multi-month dispensing (control group). Interquartile range were imposed to determine the level of adherence between health facilities, and logistic regression was performed to ascertain the associations between communities based muti-months dispensing and adherence and viral suppression.Results The study found that community-based multi-month ART dispensing was associated with higher adherence; those who disliked it also had lower adherence rates. Dispensing intervals and clinical appointment schedules improved adherence. Other factors influenced adherence, including shorter clinic wait times, preferences, adhering to clinical appointments, and reduced stigma.Conclusion Community-based multi-month dispensing of Anti-retroviral therapy significantly improves adherence among youth living with HIV. Peer-led programs show higher adherence rates, emphasising the importance of leadership and medication delivery frequency in HIV treatment programs. Addressing logistical obstacles and rationalising medication administration through multi-months can enhance adherence, improve health outcomes, and reduce HIV transmission.