A Comparative Cross-sectional Study to Examine Geographic Disparities in Violence Response Capacity among Urban and Rural Adolescent Boys in Tanzania

Background Violence Against Adolescents (VAA) is a pervasive global public health crisis, severely impacting developmental and mental health outcomes. In-school adolescent boys are a vulnerable, yet understudied, population, particularly in Sub-Saharan Africa. Existing research in Tanzania frequently adopts a national focus or centers on adolescent girls, leaving a critical knowledge gap regarding comparative burdens of Violence prevalence, knowledge, and reporting practices among boys across divergent geographic settings (rural vs. urban). This study compared these variables among in-school adolescent boys in rural versus urban Dodoma, Tanzania. Methods A comparative cross-sectional survey was conducted among 211 in-school adolescent boys (10–19 years) selected via multistage clustered sampling from rural and urban secondary schools in the Dodoma region. Data were collected using validated, standardized instruments. Geographic disparities were assessed using descriptive and inferential statistics; Multivariate logistic regression was employed to analyze prevalence, knowledge, and reporting practices, controlling for key confounders (p ≤ 0.05, α = 0.05). Results The mean age of respondents was 14 ± 0.461 years. The overall VAA prevalence was 57.8%, out of which rural adolescent boys accounted for 36.5%. Significant geographic disparity was observed; rural adolescent boys reported higher exposure to physical (15.2%), sexual (13.3%), emotional/psychological (5.7%), and neglect-based violence (2.4%) (X2 = 11.354; 95%CI: 1.236–25.822; p = 0.003). Rural boys demonstrated significantly lower VAA knowledge (40.7%) compared to their urban counterparts (27.0%). Only 24.7% of all VAA-exposed in-school adolescent boys reported the violence, with reporting significantly lower in rural (5.7%) versus urban (19.0%) settings. Urban adolescents used formal reporting channels (Police, Health Facility, Social Services/Gender Desk) more frequently (3.8%) than rural adolescent boys (1.4%). Geographical setting remained a key predictor, with urban residence increasing the odds of higher VAA knowledge (AOR = 3.893; 95%CI: 1.082–6.703; p = 0.009) and VAA reporting intention (AOR = 2.525; 95%CI: 1.024–3.861; p = 0.018) compared to their rural counterparts. Conclusion A Significant geographic disparity in VAA exists, with rural adolescent boys in Dodoma facing a disproportionate burden of violence and lower protective VAA knowledge. These findings necessitate the development of targeted, community-based interventions, policy enforcement, and awareness programs that are sex-specific, age-appropriate, culturally and contextually adapted to address the specific socio-ecological vulnerabilities of rural-urban adolescent boys in Tanzania. Addressing these disparities is crucial to upholding protection mandates and improving the long-term well-being of adolescent boys in the region. Clinical Trial Number Not Applicable.