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Impact of Medicaid Expansion on PrEP Utilization in the US: 2012–2018

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Abstract

We investigated the impact of Medicaid expansions made possible by the 2010 Affordable Care Act on HIV Pre-Exposure Prophylaxis (PrEP) utilization in the US over the period 2012–2018. We used data on PrEP utilization from Symphony Health in a difference-in-differences regression analysis with bootstrapped standard errors. We found that Medicaid Expansion resulted on average in 7.78 additional estimated PrEP users per 100,000 population on a yearly basis (z = 2.72; p = 0.007). When restricting the sample to males, Medicaid Expansion resulted in 14.67 additional PrEP users per 100,000 population each year (z = 2.5; p = 0.012). People in the age group 25–34 were those who benefitted the most from Medicaid Expansion with 16.95 additional PrEP users per 100,000 population per year attributable to Medicaid Expansion (z = 3.2; p < 0.001). States that are considering expanding Medicaid may recognize the benefits in PrEP utilization we document here.

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Correspondence to Dimitris Karletsos.

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This research was not supported by grants or dedicated funding. Aggregated, state-level, de-identified, publicly available, secondary data were used for this research. The authors declare no competing interests in activities that would be affected by this research.

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Appendix

Appendix

See Table 3.

Table 3 Sensitivity analysis—leave one state out at a time

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Karletsos, D., Stoecker, C. Impact of Medicaid Expansion on PrEP Utilization in the US: 2012–2018. AIDS Behav 25, 1103–1111 (2021). https://doi.org/10.1007/s10461-020-03070-2

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