Comparing Socio-Demographics and HIV Testing and Prevention Outcomes Between Low-Income HIV-Negative Heterosexually Active Black Women and Men with Health Insurance

Objective: This study is to compare socio-demographic, HIV testing, and prevention factors experienced by insured low-income heterosexual Black women and men. Methods: We examined cross-sectional data from Black women and men (n = 5837) recruited in 23 U.S. cities for National HIV Behavioral Surveillance June–December 2019. We compared socio-demographic and behavioral factors between groups using log-linked Poisson regression models, producing adjusted prevalence ratios and 95% confidence intervals. Results: Black women were less likely than Black men to have private insurance (aPR 0.61, 95% CI 0.50–0.74, p < 0.0001). Black women were more likely than Black men to have incomes at or below the poverty line (aPR 1.04, 95% CI 1.01–1.07, p = 0.02), be aware of PrEP (aPR 1.20, 95% CI 1.12–1.28, p < 0.0001), and have been recently tested for HIV (aPR 1.12, 95% CI 1.04, 1.20, p < 0.01). Conclusions: Despite insured status, many Black women and men experienced suboptimal access to and utilization of HIV testing and prevention services. Understanding how social conditions produce differential access to care may help inform HIV prevention interventions.