Publications by authors named "Ya-Lin A Huang"

Background: Previous studies have estimated preexposure prophylaxis (PrEP) use among persons with commercial health insurance and Medicaid. However, data are lacking regarding PrEP use among those with Medicare.

Methods: Using a previously developed algorithm, we estimated the number of Medicare beneficiaries (MBs) with fee-for-service (FFS) claims who were prescribed PrEP from 2014 to 2021.

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Objectives: It is important to monitor national HIV preexposure prophylaxis (PrEP) use in the United States. However, PrEP use data in the Veterans Health Administration (VHA) system are not included in the current monitoring surveillance. To address this gap, we examined the trends in PrEP use among U.

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Article Synopsis
  • Male-to-male sexual transmission is the leading cause of new HIV diagnoses in the U.S., highlighting the need for updated data on men who have sex with men (MSM) to inform public health strategies.
  • This analysis estimated the number and percentage of MSM in the U.S. using data from five population-based surveys, focusing on sexual behavior and self-reported identity over different time periods.
  • The findings revealed that approximately 4.2 million MSM reside in the U.S., with varying percentages reporting sexual activity with other men over the past year, five years, and their lifetime, indicating the necessity for targeted health interventions.
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  • People with HIV have a higher prevalence of hypertension (66%) compared to those without HIV (54%), with a statistically significant adjusted prevalence ratio of 1.14.
  • Among those with hypertension, people with HIV are more likely to have controlled hypertension compared to those without, indicating better management of the condition.
  • The study also highlights geographic and racial disparities, showing that Black individuals with HIV are less likely to have controlled hypertension and those from the Southern U.S. have higher hypertension rates compared to those from the Northeast.
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  • Transgender individuals, especially transgender women (TGW) and transgender men (TGM), face a higher risk of HIV but commonly have low rates of preexposure prophylaxis (PrEP) usage, despite clinical visits for gender-affirming hormone therapy (GAHT) being potential chances for HIV prevention.
  • A study analyzed data from 2014 to 2021, revealing an increase in transgender diagnosis codes and GAHT prescriptions, with notable HIV testing and PrEP usage among insured TGW (61.1% tested, 20.2% on PrEP) and TGM (48.3% tested, 10.2% on PrEP).
  • The research highlights the need to recognize transgender individuals in
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Background And Objectives: HIV preexposure prophylaxis (PrEP) is safe, effective, and was approved for adolescents in 2018. Adolescents and young adults make up 20% of HIV diagnoses in the United States. Our objective was to describe trends in adolescents prescribed PrEP during 2018 through 2021 and characteristics of these adolescents and their PrEP providers.

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Background: A study from Botswana identified an increased risk of neural tube defects (NTDs) in infants of mothers with HIV who were treated with dolutegravir around the time of conception. We aimed to examine associations of dolutegravir use with NTDs and pregnancy loss using large health-care claims databases from the USA, a country with folic acid fortification of food.

Methods: In this cohort study, we analysed health-care claims data, recorded in the Merative MarketScan commercial database (MarketScan data) and Centers for Medicare & Medicaid Services Medicaid database (Medicaid data) from Jan 1, 2008, to Dec 31, 2020.

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Hospitalizations involving fungal infections increased 8.5% each year in the United States during 2019-2021. During 2020-2021, patients hospitalized with COVID-19-associated fungal infections had higher (48.

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Pregnancy is a condition of broad interest across many medical and health services research domains, but one not easily identified in healthcare claims data. Our objective was to establish an algorithm to identify pregnant women and their pregnancies in claims data. We identified pregnancy-related diagnosis, procedure, and diagnosis-related group codes, accounting for the transition to International Statistical Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnosis and procedure codes, in health encounter reporting on 10/1/2015.

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We developed an ad hoc method to estimate the number of excess deaths among persons with HIV (PWH) during the coronavirus disease 2019 (COVID-19) pandemic in the United States. Using this method, we estimated approximately 1448 excess deaths from COVID-19 among PWH in 2020 in the United States. We also developed an Excel workbook for use as a tool to quickly assess excess deaths among PWH in settings with limited surveillance data.

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The association between thromboembolic events (TE) and COVID-19 infection is not completely understood at the population level in the United States. We examined their association using a large US healthcare database. We analyzed data from the Premier Healthcare Database Special COVID-19 Release and conducted a case-control study.

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Increasing HIV testing, preexposure prophylaxis (PrEP), and antiretroviral therapy (ART) are pillars of the federal Ending the HIV Epidemic in the U.S. (EHE) initiative, with a goal of decreasing new HIV infections by 90% by 2030.

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Objective: To assess disruption in healthcare services for HIV treatment by national emergency in response to the coronavirus disease 2019 (COVID-19) pandemic in the United States.

Design: Time-series analysis.

Methods: We analyzed the IQVIA Real World Data-Longitudinal Prescriptions Database and calculated time trends in the weekly number of persons with active antiretroviral prescriptions for HIV treatment, and of persons who obtained antiretroviral prescriptions during January 2017-March 2021.

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Article Synopsis
  • - The study investigated how the COVID-19 pandemic affected HIV pre-exposure prophylaxis (PrEP) prescriptions in the U.S. from March 2020 to March 2021, using data to project expected prescriptions without the pandemic.
  • - It found that the pandemic led to a 22% decrease in PrEP prescriptions and a 25% drop in new PrEP users compared to predicted numbers.
  • - The impact was particularly significant among younger individuals and those with commercial insurance, emphasizing the need for better access to HIV prevention during public health crises.
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We analyzed a national pharmacy database to estimate the annual number of persons who abandoned preexposure prophylaxis (PrEP) prescriptions and assessed associated factors. About 9% of persons prescribed PrEP abandoned prescriptions in 2019; abandonment was associated with sex, age, insurance type, black race/ethnicity, and drug copayment amount.

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HIV testing is a critical component of effective HIV prevention and care. CDC recommends routine opt-out HIV testing in health care settings for all sexually active persons aged 13-64 years at least once in their lifetime and risk-based testing regardless of age for those who report behaviors associated with HIV acquisition (1). However, recent studies show low HIV testing rates in clinical settings; HIV testing rates at visits to physician offices did not increase during 2009-2016 (2).

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To assess advanced practitioners' scope of practice laws (i.e., legal authority providers can prescribe regulated medications) as potential barriers to HIV pre-exposure prophylaxis (PrEP), we conducted an analysis using IQVIA Real World Data in association with scope of practice law classifications supplied by the American Association of Nurse Practitioners and scopeofpracticepolicy.

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Background: Daily oral pre-exposure prophylaxis (PrEP) is highly effective in preventing human immunodeficiency virus (HIV) infection if used adherently throughout periods of HIV risk. We estimated PrEP persistence among cohorts of persons with commercial or Medicaid insurance.

Methods: We analyzed data from the IBM MarketScan Research Database to identify persons aged 18-64 years who initiated PrEP between 2012 and 2017.

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Background: The suppression of viremia among persons with HIV (PWH) using antiretroviral therapy has been hypothesized to reduce HIV incidence at the population level. We investigated the impact of state level viral suppression among PWH in the United States on estimated HIV incidence between 2010 and 2015.

Methods: Viral suppression data and HIV incidence estimates from the National HIV Surveillance System were available from 29 states and the District of Columbia.

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Background: Use of HIV preexposure prophylaxis (PrEP) has increased nationwide, but the magnitude and distribution of PrEP medication costs across the health care system are unknown.

Objective: To estimate out-of-pocket (OOP) and third-party payments using a large pharmacy database.

Design: Retrospective cohort study.

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In 2019, the U.S. Department of Health and Human Services launched the Ending the HIV Epidemic: A Plan for America (EHE) initiative to end the U.

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Background: In 2015, there were approximately 40,000 new HIV diagnoses in the United States. Pre-exposure prophylaxis (PrEP) is an effective strategy that reduces the risk of HIV acquisition; however, uptake among those who can benefit from it has lagged. In this study, we 1) compared the characteristics of patients who were prescribed PrEP with individuals newly diagnosed with HIV infection, 2) identified the specialties of practitioners prescribing PrEP, 3) identified metropolitan statistical areas (MSAs) within the US where there is relatively low uptake of PrEP, and 4) reported median amounts paid by patients and third-party payors for PrEP.

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