Medicaid expansions are associated with increases in the percentage of people living with HIV who are aware of their status and with greater use of preexposure prophylaxis (PrEP), according to a study published in the American Journal of Preventive Medicine. Investigators estimated the effects of the Medicaid expansions using data on HIV diagnoses per 100,000 population, awareness of HIV status, and PrEP use. The analysis compared data before and after the expansions, as well as differences between treatment counties (all counties in states that expanded Medicaid) and control counties (all counties in states that did not expand Medicaid). Medicaid expansion was associated with an increase in HIV diagnoses of 0.508 per 100,000 population, or 13.9%. Medicaid expansion also was associated with improvements in the knowledge of HIV status and PrEP use. However, there were no associations seen between expansions and incident HIV, substance use, or sexually transmitted infection rates, with the exception of gonorrhea, which decreased after expansions. Changes in new HIV diagnoses, awareness of HIV status, and PrEP use were not simply due to a higher incidence or an increase in infection risk. “Expanding public health insurance may be an avenue for curbing the HIV epidemic,” the authors write.
