Impact of Being on Parental Health Insurance Plan on Ever Testing for HIV Among Young MSM, 2019 Público
Ravichandran, Ishwarya (Spring 2021)
Published
Abstract
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.
Table of Contents
Introduction
Methods
Results
Discussion
References
About this Master's Thesis
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