Date of Conferral

6-2-2025

Date of Award

June 2025

Degree

Ph.D.

School

Public Health

Advisor

Mehdi Agha

Abstract

HIV prevention and treatment disparities persist among men in Virginia, particularly in racial and ethnic minority groups. This study examined how insurance type and demographic factors influence prescriptions for antiretroviral treatment (ART) and preexposure prophylaxis (PrEP). Addressing these disparities is critical to advancing public health equity and reducing HIV rates. The purpose was to assess whether age, race, ethnicity, region, and insurance type are associated with the type of oral HIV medication prescribed. Guided by the HIV prevention and care cascade frameworks, the study focused on access and adherence. Using a cross-sectional quantitative design, the study analyzed secondary data from 40,717 men aged 20–85 in Virginia prescribed ART or PrEP between 2019–2021 from eHARS and Provide Enterprise maintained by the Virginia Department of Health. The research found associations between demographic characteristics, insurance type, and HIV medication prescriptions. Descriptive statistics, ANOVA, t-tests, and logistic regression were used for analysis. Black men (57% of HIV cases) and Hispanic men (10%) were significantly less likely to receive PrEP compared to White men. Those on Medicare/Medicaid were more likely to receive ART (64%), while those with commercial insurance were more likely to receive PrEP (71%). The Central and Eastern regions had the highest prescription rates. These results highlight significant disparities by insurance type and race. Findings can inform targeted outreach and policy changes to improve access to HIV medications and advance positive social change for underserved populations in Virginia.

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