posted on 2024-07-08, 07:03authored byJohannes ThrulJohannes Thrul, H Yusuf, J Devkota, J Owczarzak, ET Ohene-Kyei, K Gebo, A Agwu
Background: Providers caring for adolescents and young adults with HIV (AYA-HIV) mostly base their adherence counseling during clinical encounters on clinical judgment and expectations of patients’ medication adherence. There is currently no data on provider predictions of viral suppression for AYA-HIV. We aimed to assess the accuracy of provider predictions of patients’ viral suppression status compared to viral load results. Methods: Providers caring for AYA-HIV were asked to predict the likelihood of viral suppression of patients before a clinical encounter and give reasons for their predictions. Provider predictions were compared to actual viral load measurements of patients. Patient data were abstracted from electronic health records. The final analysis included 9 providers, 28 patients, and 34 observations of paired provider predictions and viral load results. Results: Provider prediction accuracy of viral suppression was low (59%, Cohen's Kappa = 0.16). Provider predictions of lack of viral suppression were based on nonadherence to medications, new patient status, or structural vulnerabilities (e.g., unstable housing). Anticipated viral suppression was based on medication adherence, history of viral suppression, and the presence of family or other social forms of support. Conclusions: Providers have difficulty accurately predicting viral suppression among AYA-HIV and may base their counseling on incorrect assumptions. Rapid point-of-care viral load testing may provide opportunities to improve counseling provided during the clinical encounter.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was facilitated by the infrastructure and resources provided by the Johns Hopkins University Center for AIDS Research, an NIH-funded program (P30 AI094189), which is supported by the following NIH cofunding and participating institutes and centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIA, NIGMS, NIDDK, and NIMHD. The content is solely the authors’ responsibility and does not necessarily represent the official views of the NIH.
History
Publication Date
2024-05-25
Journal
Journal of the International Association of Providers of AIDS Care