Presentation (CTI)

OBJECTIVES: COVID-19 negatively disrupted healthcare access for people living with HIV (PLWH), yet there are few analyses describing the impacts of the COVID-19 pandemic on health care resource utilization for PLWH in the US. We conducted a descriptive analysis of HRCU among PLWH in the US to assess trends in total healthcare and prescription spending by ethnicity, geographical location, and payer before (2015-2019) and after (2020-2023) the pandemic.
METHODS: Publicly available data from the Medical Expenditure Panel Survey (MEPS) were retrieved from 2015-2023. Descriptive statistics were stratified by census region, race, and payer. Expenses were adjusted to 2023 USD using the Consumer Price Index for all Urban Consumers (CPI-U) to account for inflation. Statistical comparisons were made using the Wilcoxon-Rank Sum test.
RESULTS: Comparing pre- and post-COVID data, annual aggregate spending decreased by 35.1% from $8.44B to $5.48B (p=0.0091) and annual mean spending per PLWH decreased by 24.6% from $40,257.56 to $30,356.52 post-COVID (p=0.0091). National healthcare expenditure decreased by 31%, from $11.18B to $7.71B (p=0.0098). Geographically, there were decreases in spending of 56.9% ,15.9%, and 37.7%, for the Northeast, the Midwest, and the South, respectively while a 4.6% increase was seen in the West. All ethnicities except for Asian Non-Hispanic (due to missing data) showed reduced spending, while the only significant decrease in spending was in the Black Non-Hispanic group which saw a 46.5% decrease (p=0.0307). Prescription spending declined across Medicare, Medicaid and Out-of-pocket payers’ expenditures; however, differences were non-significant.
CONCLUSIONS: The pandemic was associated with a decline in HRCU and spending among PLWH in the US, particularly among Black Non-Hispanic individuals. Overall trends suggest reduced healthcare access or utilization, highlighting potential disparities in care continuity during public health emergencies.