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Public Health Rep. 1996 Jan-Feb; 111(1): 44–54.
PMCID: PMC1381740

Counseling and testing for HIV prevention: costs, effects, and cost-effectiveness of more rapid screening tests.

Abstract

New rapid human immunodeficiency virus (HIV) antibody tests permit many individuals to receive test results and appropriate counseling at one clinic visit. Because currently used tests require significant time for processing, all individuals must return for a second visit for test results and counseling. Since return rates for the second visit are low, the more rapid tests present an opportunity to improve the efficiency of HIV counseling and testing. The authors compared the costs and effectiveness of the currently used counseling and testing procedure and a streamlined procedure made possible by the new, more rapid screening tests. When test-positive clients are given preliminary screening test results, the rapid procedure is more cost-effective than the current procedure. Since over 90% of the clients in most clinics will test negative, the rapid counseling and testing procedure allows the vast majority of clients to be counseled and tested and to receive their results and posttest counseling in one visit. However, in the case where the goal of HIV counseling and testing is to focus only on infected individuals, if information regarding a positive result from the rapid screening test is not given to clients at the initial visit before a confirmatory test is performed, then the rapid counseling and testing procedure is not more cost-effective than the current procedure.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Valdiserri RO, Moore M, Gerber AR, Campbell CH, Jr, Dillon BA, West GR. A study of clients returning for counseling after HIV testing: implications for improving rates of return. Public Health Rep. 1993 Jan-Feb;108(1):12–18. [PMC free article] [PubMed]
  • Squire SB, Elford J, Bor R, Tilsed G, Salt H, Bagdades EK, Janossy G, Griffiths PD, Johnson MA. Open access clinic providing HIV-I antibody results on day of testing: the first twelve months. BMJ. 1991 Jun 8;302(6789):1383–1386. [PMC free article] [PubMed]
  • Morris DJ, Corbitt G, Crosdale E. Same-day testing for human immunodeficiency virus antibodies. J Virol Methods. 1994 Oct;49(3):367–370. [PubMed]
  • Holtgrave DR, Valdiserri RO, Gerber AR, Hinman AR. Human immunodeficiency virus counseling, testing, referral, and partner notification services. A cost-benefit analysis. Arch Intern Med. 1993 May 24;153(10):1225–1230. [PubMed]
  • Hull HF, Bettinger CJ, Gallaher MM, Keller NM, Wilson J, Mertz GJ. Comparison of HIV-antibody prevalence in patients consenting to and declining HIV-antibody testing in an STD clinic. JAMA. 1988 Aug 19;260(7):935–938. [PubMed]
  • Jahn M. Lab salaries. Part 1: A precarious balance on the shaky dollar. MLO Med Lab Obs. 1993 Jan;25(1):24–29. [PubMed]
  • McCarthy BD, Wong JB, Muñoz A, Sonnenberg FA. Who should be screened for HIV infection? A cost-effectiveness analysis. Arch Intern Med. 1993 May 10;153(9):1107–1116. [PubMed]
  • Nahmias S, Feinstein CD. Screening strategies to inhibit the spread of AIDS. Socioecon Plann Sci. 1990;24(4):249–260. [PubMed]
  • McKay NL, Phillips KM. An economic evaluation of mandatory premarital testing for HIV. Inquiry. 1991 Fall;28(3):236–248. [PubMed]
  • Petersen LR, White CR. Premarital screening for antibodies to human immunodeficiency virus type 1 in the United States. The Premarital Screening Study Group. Am J Public Health. 1990 Sep;80(9):1087–1090. [PubMed]
  • Cleary PD, Barry MJ, Mayer KH, Brandt AM, Gostin L, Fineberg HV. Compulsory premarital screening for the human immunodeficiency virus. Technical and public health considerations. JAMA. 1987 Oct 2;258(13):1757–1762. [PubMed]
  • Mockler Richard W, Kleiman Mark A R. With this test I thee wed: evaluating premarital AIDS testing. J Policy Anal Manage. 1988 Spring;7(3):557–562. [PubMed]
  • Turnock BJ, Kelly CJ. Mandatory premarital testing for human immunodeficiency virus. The Illinois experience. JAMA. 1989 Jun 16;261(23):3415–3418. [PubMed]
  • Gelles GM. Costs and benefits of HIV-1 antibody testing of donated blood. J Policy Anal Manage. 1993 Summer;12(3):512–531. [PubMed]
  • Eisenstaedt RS, Getzen TE. Screening blood donors for human immunodeficiency virus antibody: cost-benefit analysis. Am J Public Health. 1988 Apr;78(4):450–454. [PubMed]
  • Schwartz JS, Kinosian BP, Pierskalla WP, Lee H. Strategies for screening blood for human immunodeficiency virus antibody. Use of a decision support system. JAMA. 1990 Oct 3;264(13):1704–1710. [PubMed]
  • Bloom DE, Glied S. Benefits and costs of HIV testing. Science. 1991 Jun 28;252(5014):1798–1804. [PubMed]
  • Harris RL, Boisaubin EV, Salyer PD, Semands DF. Evaluation of a hospital admission HIV antibody voluntary screening program. Infect Control Hosp Epidemiol. 1990 Dec;11(12):628–634. [PubMed]
  • Gorsky RD, MacGowan RJ, Swanson NM, DelGado BP. Prevention of HIV infection in drug abusers: a cost analysis. Prev Med. 1995 Jan;24(1):3–8. [PubMed]
  • Phillips KA, Coates TJ, Eversley RB, Catania JA. Who plans to be tested for HIV or would get tested if no one could find out the results? Am J Prev Med. 1995 May-Jun;11(3):156–162. [PubMed]
  • Higgins DL, Galavotti C, O'Reilly KR, Schnell DJ, Moore M, Rugg DL, Johnson R. Evidence for the effects of HIV antibody counseling and testing on risk behaviors. JAMA. 1991 Nov 6;266(17):2419–2429. [PubMed]
  • Holtgrave DR, Qualls NL, Curran JW, Valdiserri RO, Guinan ME, Parra WC. An overview of the effectiveness and efficiency of HIV prevention programs. Public Health Rep. 1995 Mar-Apr;110(2):134–146. [PMC free article] [PubMed]
  • Marwick C. Home testing kits for HIV apt to get FDA approval. JAMA. 1995 Mar 22;273(12):908–909. [PubMed]

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