Dr. Lorraine T. Dean, an assistant professor in the department of epidemiology at the Johns Hopkins Bloomberg School of Public Health, has received a $451,800, two-year grant from the National Institute of Nursing Research. Dr. Dean will lead the study examining the effect of out-of-pocket costs on starting daily oral pre-exposure prophylaxis (PrEP) among Black/African American and Hispanic/Latino men who have sex with men.
Daily oral PrEP is effective in preventing human immunodeficiency virus (HIV) infection. However, PrEP initiation across at-risk populations, including men who have sex with men, may be limited by out-of-pocket costs, which include copays, coinsurance, and deductibles, and could be a significant barrier to PrEP initiation and retention even among insured individuals. Despite being a commonly reported barrier to care, little is known about the impact of out-of-pocket costs on PrEP uptake.
The research team will conduct semi-structured interviews with participants to explore how out-of-pocket costs may impact beginning a PrEP regimen. After that, participants will view vignettes of varying characteristics for accessing PrEP — out-of-pocket costs, time for visits, modes of administration — and rate their willingness to take PrEP. Findings from this study aim to inform future development of interventions that address cost as a barrier to PrEP uptake, with the ultimate goal of improving outcomes in populations at highest risk for HIV acquisition.
The study team includes Dr. Philip Chan from Brown University and Dr. Julia Raifman from Boston University.
Dr. Dean’s research focus is social and economic determinants of chronic disease survivorship, focusing mostly on cancer and HIV.Tags: Friday Letter Submission