Health literacy on tuberculosis prevention and control among people living with HIV: a cross-sectional study

Background Tuberculosis (TB) remains a severe public health threat in China. People living with HIV (PLWH) face markedly higher risks of TB and TB-related mortality. Evaluating TB knowledge in this vulnerable group is critical for targeted health education, yet relevant data remain scarce. This study assessed TB awareness among PLWH to inform tailored TB health-education interventions. Methods A cross-sectional survey was conducted using random proportional sampling from October to December 2024 in Xiangyang City, Hubei Province. A total of 225 PLWH completed face-to-face questionnaires covering sociodemographic characteristics, awareness of the five core TB information items, willingness to learn, current knowledge sources, and preferred information channels. Results The overall awareness rate of core TB information among PLWH was 57.1%. Awareness varied significantly across specific items, ranging from 86.7% for “TB is an infectious disease” to only 28.0% for “TB is curable.” Lower awareness was significantly associated with rural residence (53.5% vs. urban 62.8%, p = 0.002), lower educational attainment (45.6% for junior high school or below vs. 69.4% for high school or above, p < 0.001), and being married or divorced/widowed compared to being unmarried ( p < 0.001). Nearly all participants (98.7%) expressed willingness to learn about TB. Television was the most common current knowledge source (57.3%), whereas online media (e.g., WeChat, Douyin) was the most preferred channel (60.0%), followed by health lectures (48.0%). Conclusion TB knowledge among PLWH was insufficient, with significant gaps in transmission, prevention, and curability. The vast majority demonstrated willingness to acquire TB knowledge and future efforts are needed to prioritize the underserved subgroups (e.g., rural and less-educated individuals). Digital platforms can be effectively combined with TB education integrated into routine HIV services. Messaging must focus on transmission, prevention, and curability through standard treatment adherence.