Insurance Status and Access to Sexual Health Services Among At-Risk Men: A Qualitative Study.

Our objective was to evaluate the impact of insurance coverage on access to sexual health services among at-risk men. Data were collected from Hispanic/Latino and non-Hispanic White male patients at a publicly funded sexually transmitted disease clinic in a Medicaid expansion state from February to July 2017, using in-depth, semistructured interviews. A coding scheme was applied to interview transcripts with iterative revisions until a final coding scheme was achieved. Data were analyzed using Nvivo 10 software. Three key themes emerged from qualitative analysis: Most participants reported (a) financial barriers, (b) fluctuations in insurance status and challenges with insurance re-enrollment, and (c) lack of access to a provider and discomfort discussing sexual health as barriers to accessing HIV/sexually transmitted disease care in primary care settings. Hispanic/Latino men more frequently cited these barriers compared with non-Hispanic White men. Insurance status and out-of-pocket costs are barriers to sexual health care for at-risk men.