Methods: The cohort includes people with a diagnosis of HIV who were at least 18 years old, enrolled in ADAP before July 1, 2013, and eligible for ACA insurance. The Virginia Department of Health (VDH) provided a database with data collected from January 1, 2013 through December 31, 2014.
Results: Of Virginia’s 3933 ACA-eligible ADAP clients, 47.1% enrolled in ACA insurance plans. In multivariable binary logistic regression analysis assessing factors associated with ACA enrollment, age, race/ethnicity, sex, Income/Financial Incentives, HIV/AIDS Diagnosis, 2013 ADAP Plan, and HIV Clinic were statistically significant. In multivariable binary logistic regression analysis, statistically significant factors associated with achieving HIV VL suppression include ACA enrollment (OR 1.45, p=0.006), starting with an undetectable HIV VL in 2013, more time between VLs, HIV/AIDS diagnosis, and HIV clinic.
Conclusion: This unique and timely project creates a statewide picture of the transition of the ADAP care delivery model in Virginia, a state without Medicaid expansion. This analysis demonstrates that across demographic and systems-level factors, there was variability in ADAP clients’ ACA insurance enrollment. Importantly, ACA enrollment in 2014 was associated with HIV VL suppression, an essential outcome for the individual and for public health. This association should continue to be tracked over time, as more PLWH enroll in insurance programs and remain on insurance for longer periods of time.
L. Yerkes, None
S. Bailey, None
R. Dillingham, None
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