ArticleSexual and reproductive health matters2025
Declines in HIV testing and diagnoses: a policy analysis of the 2019 Title X federal regulations on family planning clinics.
Article in Sexual and reproductive health matters, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
In 2019 the Trump administration instituted a federal regulation (hereinafter the Policy) requiring that Title X family planning clinics have financial and physical separation of abortion services from other health services, and prohibited abortion referrals. In response, 32% (1,280) of Title X funded sites left the programme nationally. Our analysis connects public data from Title X Family Planning Reports (2016-2021) and CDC surveillance reports (2016-2021), to examine the Policy's impact on: (1) HIV testing at Title X clinics by region, and (2) the proportion of a region's total HIV diagnoses at Title X clinics. We use mixed multivariable linear regression modelling to examine interactions between "high" regional-level Policy exposure (defined as >25% Policy-related clinic withdrawal from the programme) and pre- and post-Policy implementation for HIV outcomes. Interaction models showed that while in effect the Policy resulted in 69,626 fewer HIV tests (95% CI -108,893 to -30,359
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