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Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention

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  • Rupa R Patel
  • Leandro Mena
  • Amy Nunn
  • Timothy McBride
  • Laura C Harrison
  • Catherine E Oldenburg
  • Jingxia Liu
  • Kenneth H Mayer
  • Philip A Chan

Abstract

Pre-exposure prophylaxis (PrEP) can reduce U.S. HIV incidence. We assessed insurance coverage and its association with PrEP utilization. We reviewed patient data at three PrEP clinics (Jackson, Mississippi; St. Louis, Missouri; Providence, Rhode Island) from 2014–2015. The outcome, PrEP utilization, was defined as patient PrEP use at three months. Multivariable logistic regression was performed to determine the association between insurance coverage and PrEP utilization. Of 201 patients (Jackson: 34%; St. Louis: 28%; Providence: 28%), 91% were male, 51% were White, median age was 29 years, and 21% were uninsured; 82% of patients reported taking PrEP at three months. Insurance coverage was significantly associated with PrEP utilization. After adjusting for Medicaid-expansion and individual socio-demographics, insured patients were four times as likely to use PrEP services compared to the uninsured (OR: 4.49, 95% CI: 1.68–12.01; p = 0.003). Disparities in insurance coverage are important considerations in implementation programs and may impede PrEP utilization.

Suggested Citation

  • Rupa R Patel & Leandro Mena & Amy Nunn & Timothy McBride & Laura C Harrison & Catherine E Oldenburg & Jingxia Liu & Kenneth H Mayer & Philip A Chan, 2017. "Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-7, May.
    • Handle: RePEc:plo:pone00:0178737
    DOI: 10.1371/journal.pone.0178737
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    Cited by:

    1. Carter, Jarvis W. & Salabarría-Peña, Yamir & Fields, Errol L. & Robinson, William T., 2022. "Evaluating for health equity among a cluster of health departments implementing PrEP services," Evaluation and Program Planning, Elsevier, vol. 90(C).
    2. Salabarría-Peña, Yamir & Douglas, Chelsea & Brantley, Meredith & Johnson, Amy K., 2022. "Informing the future of PrEP navigation: Findings from a five-site cluster evaluation," Evaluation and Program Planning, Elsevier, vol. 90(C).

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