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Patterns of HIV testing among women diagnosed with invasive cervical cancer in the New Jersey Medicaid Program

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Abstract

Purpose

Practice-based guidelines recommend HIV testing during initial invasive cervical cancer (ICC) workup. Determinants of HIV testing during diagnosis of AIDS-defining cancers in vulnerable populations, where risk for HIV infection is higher, are under-explored.

Methods

We examine factors associated with patterns of HIV testing among Medicaid enrollees diagnosed with ICC. Using linked data from the New Jersey State Cancer Registry and New Jersey Medicaid claims and enrollment files, we evaluated HIV testing among 242 ICC cases diagnosed from 2012 to 2014 in ages 21–64 at (a) any point during Medicaid enrollment (2011–2014) and (b) during cancer workup 6 months pre ICC diagnosis to 6 months post ICC diagnosis. Logistic regression models identified factors associated with HIV testing.

Results

Overall, 13% of women had a claim for HIV testing during ICC workup. Two-thirds (68%) of women did not have a claim for HIV testing (non-receipt of HIV testing) while enrolled in Medicaid. Hispanic/NH-API/Other women had lower odds of non-receipt of HIV testing compared with NH-Whites (OR: 0.40; 95% CI: 0.17–0.94). Higher odds of non-receipt of HIV testing were observed among cases with no STI testing (OR: 4.92; 95% CI 2.27–10.67) and < 1 year of Medicaid enrollment (OR: 3.07; 95% CI 1.14- 8.26) after adjusting for other factors.

Conclusions

Few women had HIV testing claims during ICC workup. Opportunities for optimal ICC care are informed by knowledge of HIV status. Further research should explore if lack of HIV testing claims during ICC workup is an accurate indicator of ICC care, and if so, to assess testing barriers during workup.

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Acknowledgments

We thank Joel Cantor, Derek DeLia, and Margaret Koller from the Rutgers Center for State Health Policy and Gerald Harris from the New Jersey State Cancer Registry for their early contributions and guidance to the initial data linkage activities.

Funding

This study was supported in part by a CINJ Cancer Prevention and Control Pilot Award (P30CA072720). Jennifer Tsui is supported by an American Cancer Society Mentored Research Scholar Grant (MRSG-17–099-01-CPHPS). Jennifer McGee-Avila and Michelle Doose are supported by the Robert Wood Johnson Foundation Health Policy Research Scholars program. New Jersey State Cancer Registry data were collected through funding by NCI SEER contract #HHSN261201300021I, by CDC NPCR #5U58DP003931-02, the State of New Jersey, and the Rutgers CINJ.

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Authors and Affiliations

  1. School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, USA

    Jennifer K. McGee-Avila

  2. François-Xavier Bagnoud Center, Rutgers, The State University of New Jersey, Newark, NJ, USA

    Jennifer K. McGee-Avila

  3. School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA

    Michelle Doose, Antoinette M. Stroup & Jennifer Tsui

  4. Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA

    Michelle Doose, Antoinette M. Stroup & Jennifer Tsui

  5. Center for State Health Policy, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA

    Jose Nova & Jennifer Tsui

  6. Department of Sociology, University of Maryland, College Park, College Park, MD, USA

    Rizie Kumar

  7. New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, NJ, USA

    Antoinette M. Stroup

  8. Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA

    Jennifer Tsui

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  1. Jennifer K. McGee-Avila
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  2. Michelle Doose
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  3. Jose Nova
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  6. Jennifer Tsui
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Correspondence to Jennifer Tsui.

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Table 3 CPT/ICD-9/HCPCS STI testing codes for medicaid claims
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McGee-Avila, J.K., Doose, M., Nova, J. et al. Patterns of HIV testing among women diagnosed with invasive cervical cancer in the New Jersey Medicaid Program. Cancer Causes Control 31, 931–941 (2020). https://doi.org/10.1007/s10552-020-01333-w

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