Potential Healthcare Insurance and Provider Barriers to Pre-Exposure Prophylaxis Utilization Among Young Men Who Have Sex with Men
Authors
Marks, Sarah J.Merchant, Roland C.
Clark, Melissa A.
Liu, Tao
Rosenberger, Joshua G.
Bauermeister, Jose
Mayer, Kenneth H.
UMass Chan Affiliations
Center for Health Policy and Research, Commonwealth MedicineDepartment of Quantitative Health Sciences
Document Type
Journal ArticlePublication Date
2017-11-01Keywords
HIVPrEP
YMSM
healthcare
Community Health and Preventive Medicine
Health Economics
Health Policy
Health Services Administration
Immune System Diseases
Virus Diseases
Metadata
Show full item recordAbstract
Young adult men-who-have-sex-with-men (YMSM) continue to have among the highest incidence of HIV infection in the United States. Pre-exposure prophylaxis (PrEP) is an effective and safe method of preventing HIV infection; however, despite US Food and Drug Administration approval, utilization remains low, in part, due to structural barriers, particularly access to healthcare. In this study, we used social media to recruit black, Hispanic, and white HIV-uninfected 18- to 24-year-old YMSM. Participants completed an online survey about their sexual behavior, healthcare access, and previous use of PrEP. Of the 2297 YMSM surveyed, only 3.4% had used PrEP. PrEP use was associated with higher levels of education, living alone, older age, higher levels of sexual activity, and greater healthcare access, specifically having healthcare insurance and a clinic or primary care provider (PCP) from whom they received care. Among PrEP nonusers, 65% met at least one of the US Centers for Disease Control and Prevention recommended indications for PrEP use, and of these, 59% had healthcare insurance and received care in a clinic and/or had a PCP. Multi-variable multi-nomial logistic regression modeling identified disparities in access to healthcare by age, race/ethnicity, education, and region. Specifically, older YMSM, blacks and Hispanics, those with fewer years of formal education, and residents of the southern and the western United States were more likely to lack healthcare access. These results demonstrate both potential opportunities and barriers to the scale-up of PrEP among YMSM.Source
AIDS Patient Care STDS. 2017 Nov;31(11):470-478. doi: 10.1089/apc.2017.0171. Link to article on publisher's siteDOI
10.1089/apc.2017.0171Permanent Link to this Item
http://hdl.handle.net/20.500.14038/29154PubMed ID
29087744Related Resources
ae974a485f413a2113503eed53cd6c53
10.1089/apc.2017.0171