Publications

PrEP Cost Analysis for Covered California Health Plans

PrEP is a highly effective medication for preventing HIV. Those interested in PrEP and enrolling in a Covered California health plan should carefully weigh the costs of a Truvada® prescription, copays for regular doctors’ visits and laboratory tests, and monthly premiums. With Gilead’s copay card, PrEP is affordable (less than $400/year) on all Covered California health plans except Bronze plans. However, this does not include the cost of monthly premiums and assumes that medical and pharmacy deductibles have not been met. You can use Covered California’s shop and compare tool to see the cost of premiums in your area at...

Addressing PrEP Disparities Among Young Gay and Bisexual Men in California

Young gay, bisexual, and other men who have sex with men (YMSM), particularly black and Latino YMSM, are at highest risk for HIV in California and across the United States. The Centers for Disease Control and Prevention estimates that if current rates persist, half of all black—and a quarter of all Latino—gay and bisexual men could be infected with HIV in their lifetimes. Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention intervention that could drastically reduce the number of new HIV infections among YMSM. PrEP uses a well-established antiretroviral medication, Truvada, to block HIV infection in at-risk HIV-negative individuals....

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...

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