Insurance enrollment is complex for people living with HIV (PLWH) and people at increased risk for HIV, in part, owing to needing to ensure access to adequate provider networks and appropriate formularies. Insurance for PLWH facilitates access to HIV care/treatment and, ultimately, viral suppression, which has the individual benefit of longevity and the public health benefit of decreased HIV transmission. For people at increased risk for HIV, access to insurance facilitates improved access to HIV biomedical prevention, which has the individual benefit of elimination of transmission risk and the public health benefit of decreased HIV transmission. The objective of this study was to explore perceptions of priorities related to plan navigation, barriers and facilitators for enrolling and maintaining insurance coverage, and questions related to regional, state, and federal policies impacting plans provided both on and off the Affordable Care Act (ACA) marketplace. We interviewed a national sample of assisters (n = 40), who specialize in insurance plan selection for these populations. We found that assisters tailor their approaches to HIV-specific and person-specific concerns by navigating challenges related to affordability, formularies, and provider networks. In a complex coverage landscape during a time of uncertainty about the long-term future of the ACA, assisters have mastered the ability to simplify the insurance selection process for a vulnerable population. Assisters have excelled at incorporating insurance literacy education and encouraging client engagement in the process. Assisters play an essential role in the current complicated and fragmented United States' health care delivery system for PLWH and people at increased risk for HIV and could be incorporated into the Ending the HIV Epidemic initiative.

中文翻译：

---

在复杂的覆盖范围内，协助艾滋病毒感染者和艾滋病毒感染风险增加的人在保险导航方面取得成功。

对于艾滋病毒感染者 (PLWH) 和艾滋病毒感染风险增加的人来说，保险注册很复杂，部分原因是需要确保获得足够的提供者网络和适当的处方集。PLWH 保险有助于获得艾滋病毒护理/治疗，并最终促进病毒抑制，这对个人长寿和减少艾滋病毒传播的公共健康有益。对于艾滋病毒感染风险较高的人群，获得保险有助于改善艾滋病毒生物医学预防，这对消除传播风险的个人利益和减少艾滋病毒传播的公共卫生利益都有好处。本研究的目的是探讨对与计划导航、障碍和促进者有关的优先事项的看法，以加入和维持保险范围，以及与影响平价医疗法案 (ACA) 市场内外提供的计划的地区、州和联邦政策相关的问题。我们采访了一个全国性的助手样本（n  = 40)，专门为这些人群选择保险计划。我们发现，辅助人员通过应对与可负担性、处方集和提供者网络相关的挑战，针对特定于 HIV 和特定于个人的问题定制他们的方法。在 ACA 的长期未来充满不确定性的时期，在复杂的承保范围内，辅助人员已经掌握了为弱势群体简化保险选择过程的能力。Assisters 在整合保险知识教育和鼓励客户参与这一过程方面表现出色。助手在当前复杂和支离破碎的美国医疗保健提供系统中发挥着重要作用，该系统为 PLWH 和艾滋病毒感染风险增加的人提供，并且可以被纳入“结束艾滋病毒流行”倡议。