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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

Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Shortages in the HIV workforce threaten equitable access to care for youth with HIV (YWH) experiencing high rates of undiagnosed infection and suboptimal engagement. Nurse practitioners (NPs) may expand HIV care capacity, but evidence is limited. Methods: We conducted a cross-sectional study in two U.S. adolescent and adult HIV programs. Electronic health record data were merged with patient-reported surveys assessing trust, adherence, and stigma across an eight-month pre- and post-COVID-19 period. Provider type's (NP vs. physician) were compared. Results: Among 109 participants (mean age 26 years), viral suppression did not differ by provider type. Youth receiving NP-led care had higher CD4 counts, more visits, greater telehealth use, and were more likely to report higher patient-provider trust. Conclusions: NP-led HIV care for youth achieved clinical outcomes comparable to physician care and was associated with higher trust and engagement, underscoring the role of nurse practitioners in strengthening the HIV workforce.
DOI: 10.1177/23259582261485418
Authors: Emily Anne Barr, Suzanne E. Courtwright, Sheryl Malone-Thomas, Lori Silveira, Deborah Kacanek, Paul Cook, Sean M. Reed, Hillary Dunlevy
Institutions: University at Buffalo, State University of New York, The University of Texas Health Science Center at Houston, Columbia University, University of Colorado Anschutz, University of Colorado Denver, Harvard University
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $2,000
OpenAlex ID: W7215101942
FWCI:
Cites: 53
Cited by:
Related to: 10