{"doi":"10.1093/cid/ciad204","title":"Health Insurance and Initiation of Direct-Acting Antivirals for Hepatitis C in US Women With Human Immunodeficiency Virus","abstract":"BACKGROUND: Direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) is well tolerated, cost-effective, and yields high sustained virologic response rates, yet it has remained financially inaccessible to many patients. METHODS: Participants of the Women's Interagency HIV Study (an observational US cohort) with human immunodeficiency virus (HIV) and HCV (RNA+) reporting no prior hepatitis C treatment were followed for DAA initiation (2015-2019). We estimated risk ratios (RRs) of the relationship between time-varying health insurance status and DAA initiation, adjusting for confounders with stabilized inverse probability weights. We also estimated weighted cumulative incidences of DAA initiation by health insurance status. RESULTS: A total of 139 women (74% Black) were included; at baseline, the median age was 55 years and 86% were insured. Most had annual household incomes ≤$18 000 (85%); advanced liver fibrosis (21%), alcohol use (45%), and recreational drug use (35%) were common. Across 439 subsequent semiannual visits, 88 women (63%) reported DAA initiation. Compared with no health insurance, health insurance increased the likelihood of reporting DAA initiation at a given visit (RR, 4.94; 95% confidence limit [CL], 1.92 to 12.8). At 2 years, the weighted cumulative incidence of DAA initiation was higher among the insured (51.2%; 95% CL, 43.3% to 60.6%) than the uninsured (3.5%; 95% CL, 0.8% to 14.6%). CONCLUSIONS: Accounting for clinical, behavioral, and sociodemographic factors over time, health insurance had a substantial positive effect on DAA initiation. Interventions to increase insurance coverage should be prioritized to increase HCV curative therapy uptake for persons with HIV.","journal":"Clinical Infectious Diseases","year":2023,"id":376745,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.952,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":414208,"name":"Danielle F. Haley","orcid":"0000-0002-4281-2731","position":1,"is_corresponding":false},{"id":352751,"name":"Jessie K. Edwards","orcid":"0000-0002-1741-335X","position":2,"is_corresponding":false},{"id":334762,"name":"Catalina Ramirez","orcid":"0000-0002-0872-0307","position":3,"is_corresponding":false},{"id":301950,"name":"Audrey L. French","orcid":"0000-0002-9776-8934","position":4,"is_corresponding":false},{"id":150354,"name":"Phyllis C. Tien","orcid":null,"position":5,"is_corresponding":false},{"id":404159,"name":"Michael Plankey","orcid":"0000-0003-4554-7483","position":6,"is_corresponding":false},{"id":329435,"name":"Anjali Sharma","orcid":"0000-0003-3717-025X","position":7,"is_corresponding":false},{"id":602391,"name":"Michael Augenbraun","orcid":"0000-0002-8277-2850","position":8,"is_corresponding":false},{"id":377121,"name":"Eric C. Seaberg","orcid":"0000-0003-1870-6071","position":9,"is_corresponding":false},{"id":262696,"name":"Kimberly Workowski","orcid":"0000-0002-9918-9493","position":10,"is_corresponding":false},{"id":409544,"name":"María L. Alcaide","orcid":"0000-0003-4648-0145","position":11,"is_corresponding":false},{"id":1140282,"name":"Svenja Albrecht","orcid":null,"position":12,"is_corresponding":false},{"id":301953,"name":"Adaora A. Adimora","orcid":"0000-0001-5035-1552","position":13,"is_corresponding":false},{"id":329431,"name":"Andrew Edmonds","orcid":"0000-0001-6768-0096","position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":null,"created_at":"2026-07-19T01:16:32.368674Z","pmid":"37021689","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}