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Healthcare access among at-risk populations is crucial to mitigate HIV transmission, yet data on the association between HIV risk and healthcare access is limited. This study examined the association between HIV risk, (i.e., injecting any drug other than those prescribed, engaging in transactional sex, receiving treatment for a sexually transmitted infection, having condomless anal sex, or having four or more lifetime sexual partners\u2014all within the past year) and healthcare access among adults in the South, adjusting for covariates. The 2022 Behavioral Risk Factor Surveillance System for Southern states was analyzed, and 191,266 respondents participated. Rao-Scott Chi-square tests and weighted logistic regression analyses using complex sampling design were performed in SAS v. 9.4. Findings suggest that U.S. adults in the South at risk for HIV had higher odds of not having health insurance coverage (OR=1.55; 95% CI: 1.34\u20131.79), not having a personal doctor (OR=2.00; 95% CI: 1.78\u20132.25), delaying routine check-ups for a year or more (OR=1.75; 95% CI: 1.57\u20131.96), and being unable to afford medical care in the past year (OR=2.26; 95% CI: 2.00\u20132.56), compared to those not at risk, for unadjusted analyses. After adjusting for covariates, findings suggest that adults in the South at risk for HIV had 1.69 higher odds of being unable to afford medical care in the past year due to financial constraints (95% CI: 1.45\u20131.97) compared to those not at risk. Among adults at risk for HIV in the South, enhancing access to HIV preventive services, particularly during public health emergencies, has the potential to mitigate HIV transmission risks and reduce the associated financial burden. This association warrants reevaluation in the post-pandemic era to guide future prevention efforts effectively.<\/jats:p>","DOI":"10.1007\/s10461-025-04929-y","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T14:53:33Z","timestamp":1761663213000},"page":"907-916","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between HIV Risk and Health Care Access Among U.S. Adults in the South: Insights from the 2022 Behavioral Risk Factor Surveillance System"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9405-5852","authenticated-orcid":false,"given":"Precious Patrick","family":"Edet","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3631-5296","authenticated-orcid":false,"given":"Azad R.","family":"Bhuiyan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6024-630X","authenticated-orcid":false,"given":"Edith","family":"Ezekwe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6884-9535","authenticated-orcid":false,"given":"Abdul R.","family":"Shour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3556-5717","authenticated-orcid":false,"given":"Trisha","family":"Arnold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8115-0390","authenticated-orcid":false,"given":"Amy","family":"Nunn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,28]]},"reference":[{"key":"4929_CR1","unstructured":"U.S. Department of Health and Human Services. 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The CDC administers the process of collecting and releasing this data, doing so in compliance with applicable rules as well as regulations enacted by statute [\n                      \n                      ,\n                      \n                      ].","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"The 2022 BRFSS obtained informed consent from all individuals during the initial data collection, ensuring that only those who consented participated in the survey [\n                      \n                      ]. Since this study used de-identified, publicly accessible secondary data from the 2022 BRFSS, no further informed consent was required.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human Ethics and Consent to Participate (Informed Consent)"}}]}}