Health Insurance Coverage, Clinical Outcomes, and Health-Related Quality of Life Among Youth Born to Women Living With HIV.

Autor:	Lemon TL; Center for Global Health, Massachusetts General Hospital, Boston, MA., Tassiopoulos K; Center for Global Health, Massachusetts General Hospital, Boston, MA., Tsai AC; Center for Global Health, Massachusetts General Hospital, Boston, MA.; Mongan Institute, Massachusetts General Hospital, Boston, MA.; Department of Psychiatry Harvard Medical School, Boston, MA., Cantos K; Center for Global Health, Massachusetts General Hospital, Boston, MA.; IQVIA Epidemiology & Drug Safety, Cambridge, MA., Escudero D; Center for Global Health, Massachusetts General Hospital, Boston, MA., Quinn MK; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA., Kacanek D; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA., Berman C; Center for Global Health, Massachusetts General Hospital, Boston, MA., Salomon L; Center for Global Health, Massachusetts General Hospital, Boston, MA., Nichols S; Department of Neurosciences, University of California, San Diego San Diego, CA; and., Chadwick EG; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL., Seage GR 3rd; Center for Global Health, Massachusetts General Hospital, Boston, MA., Williams PL; Center for Global Health, Massachusetts General Hospital, Boston, MA.; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, MA.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2023 Jan 01; Vol. 92 (1), pp. 6-16.
DOI:	10.1097/QAI.0000000000003100
Abstrakt:	Background: Although sustained access to health care is essential, little is known about the relationship between insurance coverage and health among people born to women living with HIV (WLHIV). Setting: Prospective cohort studies of youth and young adults born to WLHIV from 2007 to 2019. Methods: We used adjusted generalized estimating equation models to estimate mean differences in, and relative risks (RRs) of, health-related quality of life (HR-QoL) and HIV disease measures over time by insurance status. HR-QoL scales with limited variability were dichotomized. Modified Poisson models were used to estimate RRs. Results: Six hundred sixty-nine Adolescent Master Protocol (AMP) youth [66% living with perinatally-acquired HIV (PHIV), 72% Black] and 939 AMP Up/AMP Up Lite young adults (89% PHIV, 68% Black) reported insurance. Most were publicly insured (87% youth, 67% young adults). Privately insured young adults living with PHIV had lower risk of antiretroviral therapy nonadherence [adjusted RR (aRR): 0.82, 95% CI: 0.70 to 0.97] than those with public insurance. There was a lower risk of suboptimal role functioning for young adults with private insurance (aRR: 0.58, 95% CI: 0.35 to 0.97) and those unaware of their coverage (aRR: 0.41, 95% CI: 0.21 to 0.78). Young adults with private insurance had higher health perception scores than those with public insurance (adjusted mean difference: 3.87, 95% CI: 0.37 to 7.38). For youth, we observed no differences in HR-QOL and HIV disease measures by insurance. Conclusion: These findings suggest meaningful differences in antiretroviral therapy adherence and some HR-QoL outcomes by health insurance coverage among young adults born to WLHIV. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu