Artificial Intelligence Meets HIV Education: Comparing Three Large Language Models on Accuracy, Readability, and Reliability

Abstract

Background This study compares three large language models (LLMs) in answering common HIV questions, given ongoing concerns about their accuracy and reliability in patient education. Methods Models answered 63 HIV questions. Accuracy (5-point Likert), readability (Flesch-Kincaid, Gunning Fog, Coleman-Liau), and reliability (DISCERN, EQIP) were assessed. Results Claude 3.7 Sonnet showed significantly higher accuracy (4.54 +/- 0.44) compared to ChatGPT-4o (4.29 +/- 0.49) and Gemini Advanced 2.0 Flash (4.31 +/- 0.50) (p < .001). ChatGPT-4o had lower accuracy in disease definition, follow-up, and transmission routes, while Gemini Advanced 2.0 Flash performed poorly in daily life and treatment-related questions. Readability analyses indicated ChatGPT-4o produced the most accessible content according to Flesch-Kincaid and Coleman-Liau indices, whereas Claude 3.7 Sonnet was most comprehensible by Gunning Fog standards. Gemini Advanced 2.0 Flash consistently generated more complex texts across all readability measures (p < .001). Regarding reliability, Claude 3.7 Sonnet achieved "good" quality on DISCERN, while others were rated "moderate" (p = .059). On EQIP, Claude 3.7 Sonnet (median 61.8) and ChatGPT-4o (55.3) were classified as "good quality with minor limitations," whereas Gemini Advanced 2.0 Flash (41.2) was rated "low quality" (p = .049). Conclusions Claude 3.7 Sonnet is preferable for accuracy and reliability, while ChatGPT-4o offers superior readability. Selecting LLMs for HIV education should consider accuracy, readability, and reliability, emphasizing regular assessment of content quality and cultural sensitivity.Background: This study compares three large language models (LLMs) in answering common HIV questions, given ongoing concerns about their accuracy and reliability in patient education. Methods: Models answered 63 HIV questions. Accuracy (5-point Likert), readability (Flesch-Kincaid, Gunning Fog, Coleman-Liau), and reliability (DISCERN, EQIP) were assessed. Results: Claude 3.7 Sonnet showed significantly higher accuracy (4.54 ± 0.44) compared to ChatGPT-4o (4.29 ± 0.49) and Gemini Advanced 2.0 Flash (4.31 ± 0.50) (p &lt; .001). ChatGPT-4o had lower accuracy in disease definition, follow-up, and transmission routes, while Gemini Advanced 2.0 Flash performed poorly in daily life and treatment-related questions. Readability analyses indicated ChatGPT-4o produced the most accessible content according to Flesch-Kincaid and Coleman-Liau indices, whereas Claude 3.7 Sonnet was most comprehensible by Gunning Fog standards. Gemini Advanced 2.0 Flash consistently generated more complex texts across all readability measures (p &lt; .001). Regarding reliability, Claude 3.7 Sonnet achieved “good” quality on DISCERN, while others were rated “moderate” (p = .059). On EQIP, Claude 3.7 Sonnet (median 61.8) and ChatGPT-4o (55.3) were classified as “good quality with minor limitations,” whereas Gemini Advanced 2.0 Flash (41.2) was rated “low quality” (p = .049). Conclusions: Claude 3.7 Sonnet is preferable for accuracy and reliability, while ChatGPT-4o offers superior readability. Selecting LLMs for HIV education should consider accuracy, readability, and reliability, emphasizing regular assessment of content quality and cultural sensitivity. © 2025 Elsevier B.V., All rights reserved.