Self‐reported <scp>HIV</scp> viral load is reliable and not affected by adverse lived experiences of women living with <scp>HIV</scp> in British Columbia
Bibliographic record
Abstract
INTRODUCTION: HIV viral load (VL) is a key predictor of long-term health for women living with HIV. Here, we investigate how HIV VL self-reported by women living with HIV enrolled in the British Columbia CARMA-CHIWOS Collaboration Study relates to clinically measured HIV VL. Three HIV-related stigma scales and associations with selected socio-demographic characteristics, such as lifetime history of homelessness, history of substance use, ethnicity, and knowledge about 'Undetectable = Untransmittable', were also examined. METHODS: For 219 women enrolled between December 2020 and August 2023, self-reported HIV VL status (classified as undetectable ≤40 copies/mL or detectable >40 copies/mL) was compared with HIV VL obtained from chart review closest to, but before the date of self-report (SR). Sensitivity, specificity, predictive values, and likelihood ratios were calculated for the study sample overall and for socio-demographically defined subgroups. Concordance between self-reported HIV VL and (CC) clinical chart-derived values was examined by Cohen's kappa. Three HIV-related stigma scores were compared between women stratified by the concordance of their self-reported and chart review-based HIV VL. RESULTS: Ninety-five percent (208/219) of women were able to estimate their most recent HIV VL via self-report, and among them, 96% (200/208) were on antiretroviral therapy, 50% reported a history of homelessness, and 30% reported current substance use. Overall, the self-reported HIV VL was correctly estimated by 189 out of 219, and showed high overall concordance (86%) and moderate agreement (Cohen's kappa = 0.55) with HIV VL values derived from CCs. Correctly self-reported undetectable HIV VL showed high sensitivity (97.2%) and positive likelihood ratio (1.92), low negative likelihood ratio (0.06), moderate specificity (50%), and performed similarly across socio-demographic subgroups. HIV stigma scores did not differ between women who estimated their HIV VL correctly versus incorrectly. Of note, knowledge about 'Undetectable = Untransmittable' was lower (40%) among women who were not able to estimate their most recent VL than among those who did (74%). CONCLUSIONS: Our findings confirm previous reports of high awareness of HIV VL by women in British Columbia, Canada, despite a high prevalence of adverse socio-demographic experiences in this cohort. Our data further suggest that despite highly stigmatized life experiences, women living with HIV in British Columbia have a strong awareness of their VL status.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".