192643 Health Insurance and Health Services Use in African-American and Latino Men who have Sex with Men (MSM)

Monday, November 9, 2009

Leona Bessonova, MS , Epidemiology, University of California, Irvine, Irvine, CA
Roger Detels, MD, MS , Dept. of Epidemiology, UCLA School of Public Health, Los Angeles, CA
Poor access to health insurance and medical services is a problem for ethnic minorities, particularly Hispanics/Latinos and African-Americans, and for sexual minorities such men who have sex with men (MSM). Access to health care and health insurance have not been adequately studied in individuals who are both racial/ethnic minorities and MSM. We compared health services use and health insurance coverage of Latino and African-American MSM to white MSM using data from the Los Angeles Center of the Multicenter AIDS Cohort Study (MACS). Race/ethnicity, education, clinical symptoms, health insurance, and number of medical visits were ascertained from self-administered questionnaires. CD4, CD8, and CD3 levels were measured by flow cytometry. African-American and Latino MSM were younger and more likely to report annual incomes of less than $20,000 than white MSM. Logistic regression identified age, HIV serostatus, and income, but not race/ethnicity, as predictive of health insurance. A Poisson regression analysis revealed that significant predictors of health services use were non-African American race, HIV-negative serostatus, full-time employment, income, 2+ symptoms reported, having health insurance, higher CD4 & CD8 and lower CD3 leukocyte counts. Race/ethnicity was not a significant predictor of having heath insurance in the multivariate model. We observed comparable health services use among Latino and white MSM, but lower use among African-American MSM. Health care facilities need to be more culturally sensitive and welcoming to sexual minorities, especially to African-American MSM.

Learning Objectives:
Evaluate the influence of race/ethnicity on health insurance and health services use men who have sex with men (MSM), focusing on African-American and Latino participants in the Multicenter AIDS Cohort Study

Keywords: Gay Men, Access to Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: M.S. in Epidemiology earned 08/2008 from University of California, Los Angeles, School of Public Health The abstract submitted was my work towards the Masters Thesis under the guidance of Dr. Roger Detels.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.