Kaperak Christopher, Elwood Sarah, Saint-Surin Tamara, Winstead-Derlega Christopher, Brennan Robert O, Dillingham Rebecca, McManus Kathleen A
School of Medicine, University of Virginia, Charlottesville 22908, VA, USA.
Division of Infectious Diseases and International Health, University of Virginia, Charlottesville 22908, VA, USA.
AIDS Res Treat. 2020 Dec 8;2020:6081721. doi: 10.1155/2020/6081721. eCollection 2020.
Many AIDS Drug Assistance Programs (ADAPs) purchased Affordable Care Act (ACA) Qualified Health Plans (QHPs) for low-income people living with HIV (PLWH). To date, little has been published about PLWH's perspective on the ACA. We explored ACA knowledge, HIV stigma, trust in the healthcare system, and ACA attitudes among PLWH with ADAP-funded QHPs in Virginia.
Participants were surveyed about demographic characteristics, ACA knowledge, HIV stigma, trust in various healthcare and government entities, and attitudes toward the ACA. Descriptive statistics were used. We assessed for associations (1) between baseline characteristics and correct ACA knowledge, HIV-related stigma, trust, and ACA attitudes and (2) between correct ACA knowledge and the following data: sources of ACA knowledge, HIV stigma, and trust.
Participants ( = 53) were a vulnerable population based on the assessment of social determinants of health, and 30% had correct ACA knowledge. Almost three-fourths of participants used HIV clinic case managers for ACA information. Participants who used websites for ACA information had correct ACA knowledge more often compared to those that did not (71% vs. 15%; = 0.001). Those with correct ACA knowledge had lower stigma scores compared to those without correct ACA knowledge (93.8; SD: 15.4 vs. 108; SD: 20.3; = 0.01). Participants trusted HIV clinicians more than general clinicians and insurance companies. No association was found between having correct ACA knowledge and endorsing having enough information about the ACA to understand how it will impact their HIV care.
Websites imparted accurate ACA information. HIV clinic case managers were the most used source, and HIV clinicians were a trusted source of information. HIV clinicians and case managers should consider disseminating information about the ACA and its impact on HIV care delivery via internet videos. Lack of internet and stigma are a threat to PLWH gaining actionable healthcare information.
许多艾滋病药物援助项目（ADAPs）为低收入的艾滋病毒感染者（PLWH）购买了《平价医疗法案》（ACA）合格的健康计划（QHPs）。迄今为止，关于艾滋病毒感染者对《平价医疗法案》的看法鲜有报道。我们探讨了弗吉尼亚州接受ADAP资助的QHPs的艾滋病毒感染者对《平价医疗法案》的了解、艾滋病毒污名化、对医疗保健系统的信任以及对《平价医疗法案》的态度。
对参与者进行了关于人口统计学特征、对《平价医疗法案》的了解、艾滋病毒污名化、对各种医疗保健和政府实体的信任以及对《平价医疗法案》的态度的调查。使用了描述性统计方法。我们评估了（1）基线特征与正确的《平价医疗法案》知识、与艾滋病毒相关的污名化、信任以及对《平价医疗法案》的态度之间的关联，以及（2）正确的《平价医疗法案》知识与以下数据之间的关联：《平价医疗法案》知识的来源、艾滋病毒污名化和信任。
根据健康的社会决定因素评估，参与者（n = 53）是一个弱势群体，30%的人对《平价医疗法案》有正确的了解。近四分之三的参与者通过艾滋病毒诊所的病例管理人员获取《平价医疗法案》的信息。与未使用网站获取《平价医疗法案》信息的参与者相比，使用网站获取信息的参与者更常对《平价医疗法案》有正确的了解（71%对15%；P = 0.001）。与没有正确《平价医疗法案》知识的参与者相比，有正确知识的参与者污名化得分更低（93.8；标准差：15.4对108；标准差：20.3；P = 0.01）。参与者对艾滋病毒临床医生的信任超过对普通临床医生和保险公司的信任。在对《平价医疗法案》有正确了解与认可拥有足够关于《平价医疗法案》的信息以了解其将如何影响他们的艾滋病毒治疗之间未发现关联。
网站提供了准确的《平价医疗法案》信息。艾滋病毒诊所的病例管理人员是最常被使用的信息来源，艾滋病毒临床医生是一个可信赖的信息来源。艾滋病毒临床医生和病例管理人员应考虑通过网络视频传播关于《平价医疗法案》及其对艾滋病毒治疗影响的信息。缺乏互联网和污名化对艾滋病毒感染者获取可采取行动的医疗保健信息构成威胁。
