# HIVMedQA: Benchmarking large language models for HIV medical decision support

arXiv: https://arxiv.org/abs/2507.18143 · HTML: https://mlsanity.com/paper/2507.18143/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 20 of its 56 references that are in the map.
- First posted on arXiv 24 Jul 2025.

## Builds on (most cited first, 20 of 20)

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- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
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- [ScispaCy: Fast and Robust Models for Biomedical Natural Language Processing](https://mlsanity.com/paper/1902.07669/) (2019)
- [AgentClinic: a multimodal agent benchmark to evaluate AI in simulated clinical environments](https://mlsanity.com/paper/2405.07960/) (2024)
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- [EHRNoteQA: An LLM Benchmark for Real-World Clinical Practice Using Discharge Summaries](https://mlsanity.com/paper/2402.16040/) (2024)
- [JMLR: Joint Medical LLM and Retrieval Training for Enhancing Reasoning and Professional Question Answering Capability](https://mlsanity.com/paper/2402.17887/) (2024)
- [Unmasking and Quantifying Racial Bias of Large Language Models in Medical Report Generation](https://mlsanity.com/paper/2401.13867/) (2024)
- [Few shot chain-of-thought driven reasoning to prompt LLMs for open ended medical question answering](https://mlsanity.com/paper/2403.04890/) (2024)
- [HealthQ: Unveiling Questioning Capabilities of LLM Chains in Healthcare Conversations](https://mlsanity.com/paper/2409.19487/) (2024)
- [MEDIC: Comprehensive Evaluation of Leading Indicators for LLM Safety and Utility in Clinical Applications](https://mlsanity.com/paper/2409.07314/) (2024)
- [A Benchmark for Long-Form Medical Question Answering](https://mlsanity.com/paper/2411.09834/) (2024)
- [Biomedical Large Languages Models Seem not to be Superior to Generalist Models on Unseen Medical Data](https://mlsanity.com/paper/2408.13833/) (2024)
- [MedQA-CS: Objective Structured Clinical Examination (OSCE)-Style Benchmark for Evaluating LLM Clinical Skills](https://mlsanity.com/paper/2410.01553/) (2024)

## Abstract (arXiv)

Large language models (LLMs) are emerging as valuable tools to support clinicians in routine decision-making. HIV management is a compelling use case due to its complexity, including diverse treatment options, comorbidities, and adherence challenges. However, integrating LLMs into clinical practice raises concerns about accuracy, potential harm, and clinician acceptance. Despite their promise, AI applications in HIV care remain underexplored, and LLM benchmarking studies are scarce. This study evaluates the current capabilities of LLMs in HIV management, highlighting their strengths and limitations. We introduce HIVMedQA, a benchmark designed to assess open-ended medical question answering in HIV care. The dataset consists of curated, clinically relevant questions developed with input from an infectious disease physician. We evaluated seven general-purpose and three medically specialized LLMs, applying prompt engineering to enhance performance. Our evaluation framework incorporates both lexical similarity and an LLM-as-a-judge approach, extended to better reflect clinical relevance. We assessed performance across key dimensions: question comprehension, reasoning, knowledge recall, bias, potential harm, and factual accuracy. Results show that Gemini 2.5 Pro consistently outperformed other models across most dimensions. Notably, two of the top three models were proprietary. Performance declined as question complexity increased. Medically fine-tuned models did not always outperform general-purpose ones, and larger model size was not a reliable predictor of performance. Reasoning and comprehension were more challenging than factual recall, and cognitive biases such as recency and status quo were observed. These findings underscore the need for targeted development and evaluation to ensure safe, effective LLM integration in clinical care.