The Ryan White HIV/AIDS Program (RWHAP) provides persons infected
with human immunodeficiency virus (HIV)
with services not covered by other healthcare payer types. Limited data exist
to inform policy decisions about the most appropriate role for RWHAP under the
Patient Protection and Affordable Care Act (ACA).
METHODS:
We
assessed associations between RWHAP assistance and antiretroviral therapy (ART)
prescription and viral suppression. We used data from the Medical Monitoring
Project, a surveillance system assessing characteristics of HIV-infected
adults receiving medical care in the United States. Interview and medical
record data were collected in 2009-2013 from 18 095 patients.
RESULTS:
Nearly
41% of patients had RWHAP assistance; 15% relied solely on RWHAP assistance for HIV care. Overall, 91% were prescribed ART, and
75% were virally suppressed. Uninsured patients receiving RWHAP assistance were
significantly more likely to be prescribed ART (52% vs 94%; P < .01) and
virally suppressed (39% vs 77%; P < .01) than uninsured patients without
RWHAP assistance. Patients with private insurance and Medicaid were 6% and 7%
less likely, respectively, to be prescribed ART than those with RWHAP only (P
< .01). Those with private insurance and Medicaid were 5% and 12% less
likely, respectively, to be virally suppressed (P ≤ .02) than those with RWHAP
only. Patients whose private or Medicaid coverage was supplemented by RWHAP
were more likely to be prescribed ART and virally suppressed than those without
RWHAP supplementation (P ≤ .01).
CONCLUSIONS:
Uninsured
and underinsured HIV-infected persons receiving RWHAP assistance were
more likely to be prescribed ART and virally suppressed than those with other
types of healthcare coverage.
By: Bradley H1, Viall AH1, Wortley PM1, Dempsey A2, Hauck H2, Skarbinski J1.
- 1Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
- 2HIV/AIDS Bureau, Health Resources and Services Administration, Rockville, Maryland.
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