Journal of acquired immune deficiency syndromes (1999) · 2026
A Community Located Insurance Navigation Intervention to Link Sexual and Gender Minorities in Status Neutral Care: Results From the Navigating Insurance Coverage Expansion Randomized Controlled Trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Umutoni Victoria, Eavou Rebecca, Almirol Ellen, Neumann Mary S, Rivera Juan, Schneider John A
Аннотация
BACKGROUND: Black and Hispanic/Latino sexual gender minorities are disproportionately affected by HIV. Structural determinants of health, such as health insurance coverage, drive care engagement and improve HIV care outcomes.
METHODS: Black and Hispanic/Latino sexual gender minorities and transgender persons ≥18 years of age, living in Chicago, IL, were enrolled and randomized to receive health insurance navigation (intervention) or standard of care. Primary and secondary outcomes were analyzed using 2-way contingency analyses to compare linkage-to-care rates by HIV status (HIV positive and HIV negative) and under a status-neutral framework, based on intervention assignment.
RESULTS: We enrolled 625 participants: 278 (44%) in the intervention arm and 347 (56%) in the control arm, with no substantial sociodemographic differences between study conditions. Overall, 29.7% were persons living with HIV, 14.1% identified as transgender, and 68.5% were insured. Among persons living with HIV in both study arms, 66.1% were linked to HIV care. Among participants living without HIV, in both study arms, 23.9% were linked to pre-exposure prophylaxis. Across study arms and HIV status, approximately one-third of participants (35.2%) were linked to care.
CONCLUSIONS: We found the provision of health insurance navigation before a care visit did not significantly improve linkage to care, even among participants not insured at study enrollment. This could partially be explained by the high prevalence of insurance at baseline.
METHODS: Black and Hispanic/Latino sexual gender minorities and transgender persons ≥18 years of age, living in Chicago, IL, were enrolled and randomized to receive health insurance navigation (intervention) or standard of care. Primary and secondary outcomes were analyzed using 2-way contingency analyses to compare linkage-to-care rates by HIV status (HIV positive and HIV negative) and under a status-neutral framework, based on intervention assignment.
RESULTS: We enrolled 625 participants: 278 (44%) in the intervention arm and 347 (56%) in the control arm, with no substantial sociodemographic differences between study conditions. Overall, 29.7% were persons living with HIV, 14.1% identified as transgender, and 68.5% were insured. Among persons living with HIV in both study arms, 66.1% were linked to HIV care. Among participants living without HIV, in both study arms, 23.9% were linked to pre-exposure prophylaxis. Across study arms and HIV status, approximately one-third of participants (35.2%) were linked to care.
CONCLUSIONS: We found the provision of health insurance navigation before a care visit did not significantly improve linkage to care, even among participants not insured at study enrollment. This could partially be explained by the high prevalence of insurance at baseline.