Health Care Coverage and Preexposure Prophylaxis (PrEP) Use Among Men Who Have Sex With Men Living in 22 US Cities With vs Without Medicaid Expansion, 2017
Health Care Coverage and Preexposure Prophylaxis (PrEP) Use Among Men Who Have Sex With Men Living in 22 US Cities With vs Without Medicaid Expansion, 2017
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DOI：
10.2105/ajph.2020.306035
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发表时间：
2021-04-01
影响因子：
12.7
通讯作者：
Wejnert, Cyprian
中科院分区：
文献类型：
--
作者：
Baugher, Amy R.;Finlayson, Teresa;Wejnert, Cyprian
目标。比较医疗补助扩大州和未扩大州男男性行为者（MSM）的医疗保险覆盖率和利用情况。我们使用了来自国家艾滋病毒行为监测系统的横截面加权数据，该系统使用基于场地的方法在2017年6月至12月期间访问和测试了22个美国城市的MSM （n = 8857）。我们通过使用rascott比较了医疗补助扩张州和非扩张州的男同性恋者。2 .按艾滋病毒状况分层进行检测。我们使用多变量logistic回归对医疗补助扩大、覆盖面和暴露前预防（PrEP）使用之间的关系进行建模。扩展州的MSM更有可能有保险（87.9%对71.6%），有医疗补助（21.3%对3.8%），与提供者讨论PrEP(58.8%对44.3%)，或使用PrEP（31.1%对17.5%）。医疗补助的扩大与更高的覆盖面和护理相关，包括prep .公共卫生影响。各州可能会考虑扩大医疗补助计划，以帮助结束艾滋病毒的流行。
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.2 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.