HIV Care for Adolescents and Young Adults: A Cross-Sectional Comparison of Nurse Practitioner and Physician Roles in Engagement in Care, Trust, and Clinical Outcomes
Emily Anne Barr, Suzanne E. Courtwright, Sheryl Malone-Thomas, Lori Silveira, Deborah Kacanek, Paul Cook, Sean M. Reed, Hillary DunlevyBackground
Nurse practitioners (NPs) may help address HIV workforce shortages, but evidence comparing health outcomes in youth remains limited. This study compared clinical and patient-reported outcomes among adolescents and young adults with HIV (AYA-WH) receiving NP versus physician care.
Methods
In this cross-sectional study, health record and survey data from AYA-WH (N=109) receiving care in Colorado, USA (June 2019–November 2020) were analyzed. Outcomes included viral suppression, care engagement, telehealth use, trust, adherence, and HIV stigma.
Results
Viral suppression and engagement in care were comparable between NP and physician groups. Youth receiving NP care had more visits, greater telehealth use, higher CD4 counts, and were more likely to report higher patient-provider trust. Adherence and stigma did not differ by provider type.
Conclusions
NPs are well-positioned to expand access to youth-focused HIV care while maintaining outcomes comparable to physician providers.