Title |
Changes in Cost and Insurance Challenges to Cover PrEP Between 2019 and 2021
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Published in |
JAIDS: Journal of Acquired Immune Deficiency Syndromes, June 2023
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DOI | 10.1097/qai.0000000000003180 |
Pubmed ID | |
Authors |
Alexa B. D'Angelo, Chloe Mirzayi, Pedro B. Carneiro, Christian Grov |
Abstract |
PrEP use cotinues lag estimated need among gay and bisexual men in the U.S. Studies report that challenges paying for PrEP may undermine continued use. Our study aimed to measure these challenges over time. Data were taken from a U.S. national cohort study of cisgender gay and bisexual men and transgender individuals aged 16 to 49. We analyzed data from PrEP-using participants between 2019-2021 and observed cost- and insurance-related challenges participants experienced while on PrEP across timepoints. We report McNemar and Cochrane's Q test statistics to compare differences between groups by year(s). In 2019, 16.5% (n = 828/5013) of participants were on PrEP; by 2020, 21% (n = 995/4727) were on PrEP and by 2021, 24.5% (n = 1133/4617) were on PrEP. The proportion of those experiencing challenges paying for PrEP-care decreased significantly across timepoints for clinical appointments, lab work and prescriptions. Those experiencing insurance and copay approval issues did not change significantly. Though not statistically significant, the only proportion that increased over time was those reporting PrEP-related insurance approval issues. In a post-hoc analysis, we found that those reporting PrEP use in the past year who were not currently on PrEP, were significantly more likely to report experiencing most PrEP challenges, when compared to current PrEP users. We found significant reductions in insurance and cost-related challenges between 2019 and 2021. However, those who discontinued PrEP within the past year reported greater challenges paying for PrEP, suggesting that cost and insurance issues may undermine PrEP persistence. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 3 | 75% |
Unknown | 1 | 25% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Scientists | 3 | 75% |
Members of the public | 1 | 25% |