Patel, Rupa R.Mena, LeandroNunn, AmyMcBride, TimothyHarrison, Laura C.Oldenburg, Catherine E.Liu, JingxiaMayer, KennethChan, Philip A.2017-07-142017Patel, Rupa R., Leandro Mena, Amy Nunn, Timothy McBride, Laura C. Harrison, Catherine E. Oldenburg, Jingxia Liu, Kenneth H. Mayer, and Philip A. Chan. 2017. “Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention.” PLoS ONE 12 (5): e0178737. doi:10.1371/journal.pone.0178737. http://dx.doi.org/10.1371/journal.pone.0178737.http://nrs.harvard.edu/urn-3:HUL.InstRepos:33439362Pre-exposure prophylaxis (PrEP) can reduce U.S. HIV incidence. We assessed insurance coverage and its association with PrEP utilization. We reviewed patient data at three PrEP clinics (Jackson, Mississippi; St. Louis, Missouri; Providence, Rhode Island) from 2014–2015. The outcome, PrEP utilization, was defined as patient PrEP use at three months. Multivariable logistic regression was performed to determine the association between insurance coverage and PrEP utilization. Of 201 patients (Jackson: 34%; St. Louis: 28%; Providence: 28%), 91% were male, 51% were White, median age was 29 years, and 21% were uninsured; 82% of patients reported taking PrEP at three months. Insurance coverage was significantly associated with PrEP utilization. After adjusting for Medicaid-expansion and individual socio-demographics, insured patients were four times as likely to use PrEP services compared to the uninsured (OR: 4.49, 95% CI: 1.68–12.01; p = 0.003). Disparities in insurance coverage are important considerations in implementation programs and may impede PrEP utilization.en-USEngineering and TechnologyManagement EngineeringRisk ManagementInsuranceMedicine and Health SciencesPublic and Occupational HealthPreventive MedicineProphylaxisPre-Exposure ProphylaxisBiology and Life SciencesMicrobiologyMedical MicrobiologyMicrobial PathogensViral PathogensImmunodeficiency VirusesHIVPathology and Laboratory MedicinePathogensOrganismsVirusesBiology and life sciencesRNA virusesRetrovirusesLentivirusPeople and placesGeographical locationsNorth AmericaUnited StatesRhode IslandMississippiSocial SciencesEconomicsHealth EconomicsHealth InsuranceHealth CareMedicine and health sciencesPublic and occupational healthPreventive medicineHIV preventionMissouriJournal Article2017-07-1410.1371/journal.pone.0178737