Cooley Laura A, Hoots Brooke, Wejnert Cyprian, Lewis Rashunda, Paz-Bailey Gabriela
Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, MS-E46, Atlanta, GA, 30329, USA.
AIDS Behav. 2017 Mar;21(3):615-618. doi: 10.1007/s10461-016-1567-7.
Recent policy changes have improved the ability of gay, bisexual, and other men who have sex with men (MSM) to secure health insurance. We wanted to assess changes over time in self-reported health insurance status among MSM participating in CDC's National HIV Behavioral Surveillance (NHBS) in 2008, 2011, and 2014. We analyzed NHBS data from sexually active MSM interviewed at venues in 20 U.S. cities. To determine if interview year was associated with health insurance status, we used a Poisson model with robust standard errors. Among included MSM, the overall percentage of MSM with health insurance rose 16 % from 2008 (68 %) to 2014 (79 %) (p value for trend < 0.001). The change in coverage over time was greatest in key demographic segments with lower health insurance coverage all three interview years, by age, education, and income. Corresponding with recent policy changes, health insurance improved among MSM participating in NHBS, with greater improvements in historically underinsured demographic segments. Despite these increases, improved coverage is still needed. Improved access to health insurance could lead to a reduction in health disparities among MSM over time.
近期的政策变化提高了男同性恋者、双性恋者以及其他与男性发生性关系的男性（男男性行为者）获得医疗保险的能力。我们希望评估在2008年、2011年和2014年参与美国疾病控制与预防中心国家艾滋病行为监测（NHBS）的男男性行为者中，自我报告的医疗保险状况随时间的变化情况。我们分析了在美国20个城市的场所接受访谈的性活跃男男性行为者的NHBS数据。为了确定访谈年份是否与医疗保险状况相关，我们使用了具有稳健标准误差的泊松模型。在纳入的男男性行为者中，有医疗保险的男男性行为者的总体比例从2008年的68%上升到2014年的79%，上升了16%（趋势p值<0.001）。在所有三个访谈年份中，按年龄、教育程度和收入划分的医疗保险覆盖率较低的关键人口群体中，随时间推移的覆盖率变化最大。与近期政策变化相一致，参与NHBS的男男性行为者的医疗保险有所改善，在历史上保险不足的人口群体中有更大改善。尽管有这些增长，但仍需要提高覆盖率。随着时间的推移，改善医疗保险的可及性可能会减少男男性行为者之间的健康差距。
