Ling Murtaugh Kimberly, Leibowitz Arleen, Chen Xiao, Pourat Nadereh
University of California at Los Angeles.
AIDS Educ Prev. 2020 Feb;32(1):25-35. doi: 10.1521/aeap.2020.32.1.25. Epub 2020 Feb 19.
The objective of this study was to measure HIV screening rates and variables associated with screening among new enrollees in California's Low Income Health Program (LIHP). A logit model was used to estimate associations between HIV screening and enrollment, claims, and encounter data for enrollees. HIV prevalence among new LIHP enrollees was 1.2%xd. Among 42,550 new LIHP enrollees with no prior HIV diagnosis, only 27% received screening within 12 months of their first medical evaluation. A total of 350 new HIV diagnoses were identified (incidence rate of 0.8%), exceeding the 0.1% level at which the Centers for Disease Control and Prevention (CDC) recommends routine HIV screening. California reduced screening barriers by removing required written informed consent and pretest counseling; the Affordable Care Act (ACA) eliminated cost-sharing and enhanced access. Removing financial and administrative barriers to HIV screening is necessary, but may be insufficient to reach CDC's recommended screening targets.
本研究的目的是衡量加利福尼亚州低收入健康计划（LIHP）新参保者的艾滋病毒筛查率以及与筛查相关的变量。采用逻辑模型来估计艾滋病毒筛查与参保者的参保、理赔及就诊数据之间的关联。LIHP新参保者中的艾滋病毒感染率为1.2%。在42,550名既往未被诊断出感染艾滋病毒的LIHP新参保者中，只有27%在首次医学评估后的12个月内接受了筛查。共确诊350例新的艾滋病毒感染病例（发病率为0.8%），超过了疾病控制与预防中心（CDC）建议进行常规艾滋病毒筛查的0.1%的水平。加利福尼亚州通过取消所需的书面知情同意书和检测前咨询来降低筛查障碍；《平价医疗法案》（ACA）取消了费用分摊并增加了可及性。消除艾滋病毒筛查的财务和行政障碍是必要的，但可能不足以实现CDC建议的筛查目标。
