Implementation of Health Insurance Navigation for Racial/Ethnic Minority Men Who Have Sex With Men Presenting for Community-Based HIV Testing.

Abstract

Objective: Being uninsured is a barrier to accessing HIV prevention and treatment. This study assesses the implementation of health insurance navigation.

Design: Randomized structural intervention conducted from 2018 to 2020 in Chicago, IL. Black/African American and Hispanic/Latino men who have sex with men presenting for community-based HIV testing (N = 230) were offered a single session of health insurance navigation immediately after their HIV test, regardless of HIV test result.

Methods: Using descriptive statistics, we present sociodemographic characteristics, health insurance navigation uptake, and immediate health insurance outcomes resulting from navigation.

Results: Most participants were 18-34 years of age (n = 175, 76.0%), most identified as non-Hispanic Black/African American (n = 202, 87.8%), and most were insured (n = 164, 71.3%). Half (n = 115, 50.0%) accepted navigation. Of those 115, 10 uninsured participants enrolled in health insurance (8.7%) and 21 uninsured participants had incomplete enrollment (18.3%); 80 insured participants reviewed their current plan (69.6%) and 4 insured participants changed to a plan better suited to their HIV care needs (3.5%). Almost all 115 were satisfied with the amount of time they had with the navigator (n = 114, 99.1%) and the services they received (n = 107, 93.0%).

Conclusions: Providing health insurance navigation at the time of HIV testing was an acceptable and feasible method to engage Black/African American and Hispanic/Latino men who have sex with men in health insurance education and enrollment. Community-based structural interventions are essential to reaching national public health and Ending the HIV Epidemic goals.