# Predicting the impact of cost on HIV pre-exposure prophylaxis uptake and racial/ethnic disparities among MSM

> **NIH NIH R21** · MIRIAM HOSPITAL · 2020 · $232,682

## Abstract

PROJECT SUMMARY
 Daily oral pre-exposure prophylaxis (PrEP) is effective in preventing HIV infection. However, PrEP
uptake across at-risk populations including men who have sex with men (MSM) may be limited by out-of-
pocket costs. Out-of-pocket costs include copays, coinsurance, and deductibles and may 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. We propose a mixed
methods and modeling study to determine the maximum out-of-pocket costs for optimal PrEP uptake in
different populations including Black/African American and Hispanic/Latino MSM. The specific aims of the
proposed study are to: 1) conduct 45 semi-structured interviews with MSM to explore how out-of-pocket costs
may impact PrEP uptake; and 2) model the impact of co-pays, coinsurance, and deductibles on PrEP uptake.
Findings from this pilot study will inform future development of interventions that address cost as a barrier to
PrEP uptake, and ultimately improve outcomes in populations at highest risk for HIV acquisition. This study
aligns with the high priority topic of identifying gaps in the PrEP care continuum and associated determinants
of health, and reducing racial/ethnic disparities in PrEP uptake and use as defined by the NIH and Office of
AIDS Research.

## Key facts

- **NIH application ID:** 9830675
- **Project number:** 5R21MH118019-02
- **Recipient organization:** MIRIAM HOSPITAL
- **Principal Investigator:** Philip Andrew Chan
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $232,682
- **Award type:** 5
- **Project period:** 2018-12-05 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9830675

## Citation

> US National Institutes of Health, RePORTER application 9830675, Predicting the impact of cost on HIV pre-exposure prophylaxis uptake and racial/ethnic disparities among MSM (5R21MH118019-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9830675. Licensed CC0.

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