Impact of Being on Parental Health Insurance Plan on Ever Testing for HIV Among Young MSM, 2019 Open Access

Ravichandran, Ishwarya (Spring 2021)

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Background: Young MSM have had consistently low rates of HIV testing compared to other

demographics. Investigating factors as to why that is can help lead the way for better

implementation methods to increase testing. One factor in particular that may play a part in low

testing rates for young MSM could be parental health insurance. There are no studies currently

examining whether young MSM are avoiding HIV testing due to the stigma tied to sexual

conduct and the potential lack of privacy from parental insurance. This analysis provides better

insight into whether there is an association between using parental health insurance and HIV

testing which can then inform what can be done to overcome this issue.

Methods: A cross-sectional analysis was done on participants of the 2019 American Men’s

Internet Survey (AMIS) dataset; the data was subset to those who have some form of insurance,

are 15-25 years of age, and have had anal sex in the last year (n = 2043). A Poisson regression

GEE model was used to calculate adjusted prevalence ratios (aPR) and 95% confidence intervals

(CI) for the association between ever HIV testing and parental health insurance. Supplemental

analyses were also conducted to explore whether the association existed for HIV testing in the

last year and stratified by age group (15-20 or 21-25 years).

Results: Most of the 2,042 participants were non-Hispanic white, 21-24 years old,

homosexual/gay-identified, and did not live alone. Overall, 72.9% (1488/2042) of participants in

the study were on parental health insurance and 72.8% (1083/1488) had been HIV tested at least

once in their life. There were no significant differences in ever HIV testing between those on

parental health insurance (72.8%; 1083/1488) versus other insurance (74.7%; 414/554; aPR: 1.01

95% CI: .89,1.15) while controlling for housing status, age, number of partners in last year, age,

and sexual identity. There were still no associations between parental health insurance and HIV

testing in all supplemental analyses.

Conclusion: In our sample of young and insured MSM, being on parental health insurance did

not appear to be a barrier to HIV testing. This may be because young MSM are unfamiliar with

the potential disclosure of their testing to their parent as the primary policy-holder, are

unconcerned with those potential disclosures, or they are accessing free/low-cost HIV testing

that doesn’t require insurance. Regardless, future work should include implementation of safer,

private testing methods for young MSM such as at-home testing and state legislation to create

privacy protections for dependents on parental insurance.

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