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Title: An Economic Analysis of Factors Associated With Preexposure Prophylaxis for Hiv Prevention Use Among Women
Citation Type: Dissertation/Thesis
Publication Year: 2023
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Abstract: Background: The lifetime cost for one HIV infection is $326,500, and the medical cost saved from one averted infection is $229,800. Plans for ending the epidemic in the U.S involves the use of antiretroviral drugs as preexposure prophylaxis (PrEP), a major prevention strategy for reducing HIV infections. However, PrEP use has not been proportional to the need. Despite comparable HIV risk as men, women account for only 5% of PrEP users annually. Research suggests that PrEP ue is highest in states that expanded Medicaid. The gender disparity in PrEP use, however, suggests that other factors specific to women may be negatively impacting their PrEP uptake. The goal of this study was to therefore determine the factors influencing the PrEP use for women across the U.S. using data dating back to 2012, when PrEP was first approved. Methods: This quasi-experimental study used a difference-in-differences regression model to examine the effect of access to healthcare on PrEP use for men and women across the U.S. We hypothesized that states with expanded Medicaid, with greater availability of mental health and substance use disorder treatment, and with greater concentration of family planning clinics are associated with higher PrEP use in women. Results: The results showed that average PrEP use was higher in states that expanded Medicaid, but men had consistently higher PrEP use than women across states. The difference-in-differences model showed a larger percentage increase in both PrEP rate (18.9% v 8.1%) and PNR (42.9% v 17.6%) for men compared with women. Conversely, the availability of healthcare services did not have the expected effect on PrEP use. Conclusions: We identified a need for more tailored interventions to better reach women, by scaling up prevention efforts that are targeted at identifying and engaging women in PrEP care. This study provided a basis for further implementation research and policy changes that prioritizes equity for all.
Url: https://www.proquest.com/docview/2863695814?pq-origsite=gscholar&fromopenview=true
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Authors: Dion Carleen Allen, by; Advisors, Dissertation; Popovici, Ioana; Rabionet, Silvia E
Institution: Nova Southeastern University
Department: Barry and Judy Silverman College of Pharmacy
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Pages: 1-161
Data Collections: IPUMS CPS
Topics: Gender, Health, Labor Force and Occupational Structure, Work, Family, and Time
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