National Survey of US HIV Clinicians: Knowledge and Attitudes About the Affordable Care Act and Opinions of its Impact on Quality of Care and Barriers to Care.

backgroundThe Affordable Care Act's (ACA's) major reforms started in 2014. In addition to assessing HIV clinicians' ACA knowledge and attitudes, this study aims to evaluate HIV clinicians' perspectives on whether the ACA has impacted the quality of HIV care and whether it addresses the main barriers to HIV care.

methodsHIV clinicians were emailed a survey weblink in 2018. Descriptive statistics, Mann-Whitney

resultsOf the 211 survey participants, the majority (70%) answered all 4 knowledge questions correctly. About 80% knew correctly whether their state had expanded Medicaid. Participants from Medicaid expansion states were more likely to report an improved ability to provide high-quality care compared with participants from Medicaid nonexpansion states (50% vs 34%;

conclusionsHIV clinicians in Medicaid expansion states were more likely to report an improved ability to provide high-quality care since ACA implementation compared with those in Medicaid nonexpansion states. However, HIV clinicians across the United States are concerned that the ACA does not address the main barriers to HIV care. To be successful, the "Ending the HIV Epidemic" initiative should address these identified barriers.