# HIV Care for Adolescents and Young Adults: Comparing Nurse Practitioner and Physician Care in Engagement, Trust, and Clinical Outcomes

## TL;DR

Nurse practitioners can provide HIV care for young adults with results as good as physicians, and may improve trust and engagement.

## Contribution

Demonstrates that NP-led HIV care for youth achieves comparable clinical outcomes and higher trust than physician-led care.

## Key findings

- Viral suppression was similar between NP-led and physician-led care.
- Youth with NP-led care had higher CD4 counts, more visits, and greater telehealth use.
- Patients reported higher trust in nurse practitioners compared to physicians.

## Abstract

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.

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.

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.

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.