Health Care Coverage and Preexposure Prophylaxis (PrEP) Use Among MenWho Have Sex With Men Living in 22 US Cities With vs Without Medicaid Expansion, 2017

Objectives. To compare health care coverage and utilization between men who have sex with men (MSM) in Medicaid expansion versus nonexpansion states. Methods. We used cross-sectional weighted data from the National HIV Behavioral Surveillance system, which used venue-based methods to interview and t...

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Bibliographic Details
Published in:American journal of public health (1971) 2021-04, Vol.111 (4), p.743-751
Main Authors: Baugher, Amy R, Finlayson, Teresa, Lewis, Rashunda, Sionean, Catlainn, Whiteman, Ari, Wejnert, Cyprian
Format: Article
Language:English
Subjects:
Chi-square test
Disease prevention
Ethnicity
Family income
Gays & lesbians
Government programs
Health care
Health care access
Health care policy
Health surveillance
Hispanic Americans
HIV
Human immunodeficiency virus
Indigent care
Insurance coverage
Medicaid
Men who have sex with men
Mens health
Patient Protection & Affordable Care Act 2010-US
Poverty
Prophylaxis
Public health
Regression analysis
Regression models
Sexually transmitted diseases
Statistical tests
STD
Surveillance
Uninsured people
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Summary:Objectives. To compare health care coverage and utilization between men who have sex with men (MSM) in Medicaid expansion versus nonexpansion states. Methods. We used cross-sectional weighted data from the National HIV Behavioral Surveillance system, which used venue-based methods to interview and test MSM in 22 US cities from June through December, 2017 (n = 8857). We compared MSM in Medicaid expansion versus nonexpansion states by using the RaoScott χ2 test stratified by HIV status. We used multivariable logistic regression to model the relationship between Medicaid expansion, coverage, and preexposure prophylaxis (PrEP) use. Results. MSM in expansion states were more likely to have insurance (87.9% vs 71.6%), have Medicaid (21.3% vs 3.8%), discuss PrEP with a provider (58.8% vs 44.3%), or use PrEP (31.1% vs 17.5%). Conclusions. Medicaid expansion is associated with higher coverage and care, including PrEP. Public Health Implications. States may consider expanding Medicaid to help end the HIV epidemic. (Am J Public Health. 2021;111:743-751. https://doi.org/10.2105/AJPH.2020.306035)
ISSN:0090-0036
DOI:10.2105/AJPH.2020.306035