Date of Conferral

2017

Degree

Ph.D.

School

Public Health

Advisor

Ernest Ekong

Abstract

People living with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS; PLWHA) are at increased risk of insufficient medical care due to lack of insurance. Inadequate medical care for PLWHA contributes to increases in HIV transmission rates. The U.S. Surveillance Report noted that in 2015, over 1.2 million people were living with HIV infection, and there were approximately 50,000 new infections every year. The report further stated that about 675,000 people have died from HIV-related illnesses since its discovery in 1981. The implementation of the Affordable Care Act (ACA) in 2014 was intended to provide Americans, including people at risk of or living with HIV, options for health insurance coverage and better access to health care. It was also designed to allow people with existing health conditions such as HIV to reach for optimal health, irrespective of the severity of their condition. Andersen's behavioral model and economic theory provided the theoretical framework and conceptual foundation for this study's assessment of the impact of the ACA on the HIV care continuum. This quantitative study used secondary data with a retrospective correlational design. Data from the Health Resources Service Administration and the Behavioral Risk Factor Surveillance System were analyzed. Overall, chi-square tests indicated a steady increase in the number of PLWHA who achieved viral suppression (Ï?2 (1) = 105, p < .001) between 2010 and 2015. Future research should include the general American population to assess the impact of the ACA. This study could lead to positive social change as PLWHA are made more aware of the benefits of comprehensive health care coverage and increase healthcare utilization, leading to improved health for those infected and less transmission of the virus.

Included in

Epidemiology Commons

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