A Playbook for Implementing Medicaid Expansion: Louisiana's Experience.

Policy Points Twelve states have yet to expand Medicaid under the Affordable Care Act (ACA). Louisiana offers a model of steps that states and counties can take to rapidly enroll eligible persons while balancing eligibility integrity and doing so within a limited administrative budget. In a post-COVID-19 health care landscape, Medicaid expansion can improve and protect population health and boost state economies, even amid budget shortfalls. Even though Louisiana compares well with other states in eligibility and enrollment efforts, future expansions may integrate other social support programs into their implementation strategies.

Interest in Pre-exposure Prophylaxis (PrEP) for HIV is Limited Among Women in a General Obstetrics & Gynecology Setting.

Pre-exposure prophylaxis (PrEP) is an important tool for reducing the risk of HIV acquisition, but identifying eligible and interested female patients remains difficult. We collected 144 surveys at urban Obstetrics & Gynecology clinics in Louisiana to assess interest in PrEP. Study participants were predominantly African-American (61.8%) and 45.1% had incomes of less than $20,000 per year. 84.7% of participants estimated their risk of HIV acquisition to be low. Initial interest in PrEP was moderate at 37.5% of the population. Number of partners, condom use, and self-perceived risk of HIV acquisition were associated with initial interest. After receiving more information about side effects and compliance requirements, only four of 144 (7.8% of initially interested, 2.8% of total) women remained interested in using PrEP. Concern about side effects was the major barrier to persistent interest. Further study is needed to determine how best to identify PrEP candidates in Obstetrics & Gynecology settings.