Publications

HIV Criminalization in California: Penal Implications for People Living with HIV/AIDS

HIV criminalization is a term used to describe statutes that either criminalize otherwise legal conduct or that increase the penalties for illegal conduct based upon a person’s HIV-positive status. While only one HIV criminalization law can be found in federal law, more than two-thirds of states and territories across the United States have enacted their own HIV criminal laws. Some HIV criminal laws do not require transmission of HIV, and in some states, these laws criminalize conduct that poses a negligible risk of transmission, such as spitting or biting. California has four HIV-specific criminal laws, and one non-HIV-specific criminal law...

Initial Health Assessments and HIV Screening Under the Affordable Care Act

The Centers for Disease Control and Prevention (CDC) estimates that 156,300 (95% CI 144,100–165,900) Americans living with HIV in 2012 were unaware of their infection. To increase knowledge of HIV status, CDC guidelines seek to make HIV screening a routine part of medical care. This paper examines how routinely California primary care providers test for HIV and how providers’ knowledge of California’s streamlined testing requirements, use of sexual histories, and having an electronic medical record prompt for HIV testing, relate to test offers. We surveyed all ten California health plans offered under health reform’s Insurance Exchange (response rate = 50%)...

Identifying a Sample of HIV-Positive Beneficiaries From Medicaid Claims Data and Estimating Their Treatment Costs

We sought to identify people living with HIV/AIDS from Medicare and Medicaid claims data to estimate Medicaid costs for treating HIV/AIDS in California. We also examined how alternate methods of identifying the relevant sample affect estimates of per capita costs. We analyzed data on Californians enrolled in Medicaid with an HIV/AIDS diagnosis reported in 2007 Medicare or Medicaid claims data. We compared alternative selection criteria by examining use of antiretroviral drugs, HIV-specific monitoring tests, and medical costs. We compared the final sample and average costs with other estimates of the size of California’s HIV/AIDS population covered by Medicaid in 2007...

TasP, PEP, and PrEP: New Hope in the Fight Against HIV/AIDS

The HIV/AIDS community is currently talking about “ending the AIDS epidemic” or “achieving an AIDS-free generation.” This conversation–optimistic, speculative, and sometimes controversial–focuses on three evidence-based HIV prevention interventions: Treatment as Prevention (TasP), Post-Exposure Prophylaxis (PEP), and Pre-Exposure Prophylaxis (PrEP). All three interventions utilize existing anti-retroviral medications to reduce transmission of HIV and prevent new infections in at-risk HIV-negative individuals. Recent research documents the potential efficacy of these interventions and the promise they hold. The purpose of this fact sheet is to explain these interventions, the data that supports them, and how Californians living with and at-risk of HIV infection will...

The Use of HIV Over-the Counter (OTC) test in California from April to September 2013

Approval in mid-2012 of a consumer-controlled OTC HIV test by the Food and Drug Administration (FDA), which is responsible for drug and medical device approval for sales to the public, has made real the possibility of learning one’s HIV status in the privacy of one’s home. Now, people who are concerned about the potential embarrassment or stigma associated with receiving an HIV test from their medical provider or in a publicly-funded HIV testing site can bypass these issues to obtain a 20-minute test result if they were willing to spend the $40-$50 to purchase an OTC HIV test at a...

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