Abstract A078: Receipt of mammography by race/ethnicity and region among Medicaid beneficiaries with and without HIV, 2001-2019

Abstract As life expectancy improves among people with HIV (PWH), further information is needed on whether PWH receive recommended cancer screening. Here, we sought to assess whether there were differences in receipt of screening mammography among women aged 50-64 years with and without HIV who enrolled in Medicaid in 2001-2019 in 27 US states. Among 4,863,522 beneficiaries (0.8% with HIV) free of breast cancer through 6 months of enrollment, we estimated crude annual incidence rates of screening mammography per 100 person-years. We also estimated the probability of receiving at least one screening mammography in the last 2 years among female beneficiaries with no history of breast cancer enrolled on December 31 of each calendar year, 2003-2019, who had at least 2 prior years of continuous follow-up. Analyses were conducted overall and stratified by race/ethnicity and US Census region. Compared to people without HIV (PWoH) in Medicaid, PWH in Medicaid were more likely to be non-Hispanic Black (52.8% vs. 18.2%) and to have enrolled in the Northeast (51.9% vs. 24.9%) or South (29.5% vs. 22.6%). Rates of screening mammography increased across calendar time from 9.2 (95% CI: 9.1, 9.3) in 2001 to 24.2 (95% CI: 24.1, 24.3) in 2019. Overall, PWH had a lower rate of mammography than PWoH in 2001-2009 (mean of 10.9 vs. 13.7) but a higher rate of mammography in 2010-2019 (mean of 21.7 vs. 19.5). Among non-Hispanic Black beneficiaries, relative to the overall trend, rates of mammography were similar in PWH but lower among PWoH, attenuating the difference in 2001-2009 (10.4 vs. 11.9) and accentuating the difference in 2010-2019 (21.4 vs. 18.8). Stratifying further by region, the 2001-2009 pattern held in the South and Midwest, and the 2010-2019 pattern held in the Northeast and South. Otherwise, rates were similar by HIV status. Among non-Hispanic white beneficiaries, in 2001-2009, rates were higher among PWH but similar among PWoH (12.1 vs 13.8); in 2010-2019, rates were lower in both groups but the difference was similar (19.9 vs. 17.8). The 2001-2009 pattern held in the Northeast, and the 2010-2019 pattern held in the South. Otherwise, rates were similar by HIV status. Similar trends were seen for the probability of receiving mammography in the last 2 years. Among PWH, the probability increased from 16% (95% CI: 15%, 18%) in 2003 to 29% (95% CI: 28%, 31%) in 2010 to 44% (95% CI: 43%, 44%) in 2019; among PWoH, the probability increased from 20% (95% CI: 19%, 20%) in 2003 to 28% (95% CI: 28%, 28%) in 2010 to 38% (95% CI: 38%, 38%) in 2019. In subgroups, findings were either consistent with the overall trend of a small difference by HIV status or there was no difference by HIV status. Among Medicaid beneficiaries, rates of mammography and the probability of receiving mammography in the past 2 years were lower among PWH than PWoH prior to 2010 but similar or higher in later calendar years. However, the probability of receiving mammography in both groups was low, indicating a need for improved screening among Medicaid beneficiaries. Citation Format: Jacqueline E. Rudolph, Keri L. Calkins, Xiaoqiang Xu, Eryka Wentz, Yiyi Zhou, Maylin Palatino, Karine Yenokyan, Bryan Lau, Corinne E. Joshu. Receipt of mammography by race/ethnicity and region among Medicaid beneficiaries with and without HIV, 2001-2019 [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A078.