BACKGROUND: In the United States, more than 2 million human immunodeficiency virus (HIV) antibody tests are performed annually at publicly funded HIV counseling and testing (CT) clinics. Clients do not receive results from one third of these tests because of low return rates. New rapid-testing technologies may improve receipt of results, but no study has systematically analyzed the costs of these newer technologies compared with the standard protocol. OBJECTIVE: To estimate and compare the economic costs associated with three HIV CT protocols: the standard protocol and the one-step and two-step rapid protocols. METHODS: A cost analysis model was developed in 2002 to calculate the intervention costs for HIV CT services with the standard CT protocol and the one-step and two-step rapid-test protocols for a hypothetical client in a publicly funded HIV clinic. Sensitivity analyses were performed to ascertain the effects of uncertainty in the model parameters. RESULTS: The one-step rapid protocol was generally the least expensive of the three protocols. The standard protocol cost less than the two-step protocol per HIV-positive client notified of his or her HIV status, but cost more per HIV-negative client. The sensitivity analysis indicated overlap in the cost estimates for HIV-negative clients, reflecting the generally similar costs of the three testing protocols. Taking into account HIV seroprevalence, the two-step rapid protocol would be less expensive than the standard protocol for most publicly funded testing programs in the United States. CONCLUSIONS: Rapid test protocols offer economic advantages as well as convenience, compared to the standard testing protocol. The cost estimates presented here should prove helpful to HIV program managers and other public health decision makers who need information on these counseling and testing technologies.
BACKGROUND: In the United States, more than 2 million human immunodeficiency virus (HIV) antibody tests are performed annually at publicly funded HIV counseling and testing (CT) clinics. Clients do not receive results from one third of these tests because of low return rates. New rapid-testing technologies may improve receipt of results, but no study has systematically analyzed the costs of these newer technologies compared with the standard protocol. OBJECTIVE: To estimate and compare the economic costs associated with three HIV CT protocols: the standard protocol and the one-step and two-step rapid protocols. METHODS: A cost analysis model was developed in 2002 to calculate the intervention costs for HIV CT services with the standard CT protocol and the one-step and two-step rapid-test protocols for a hypothetical client in a publicly funded HIV clinic. Sensitivity analyses were performed to ascertain the effects of uncertainty in the model parameters. RESULTS: The one-step rapid protocol was generally the least expensive of the three protocols. The standard protocol cost less than the two-step protocol per HIV-positive client notified of his or her HIV status, but cost more per HIV-negative client. The sensitivity analysis indicated overlap in the cost estimates for HIV-negative clients, reflecting the generally similar costs of the three testing protocols. Taking into account HIV seroprevalence, the two-step rapid protocol would be less expensive than the standard protocol for most publicly funded testing programs in the United States. CONCLUSIONS: Rapid test protocols offer economic advantages as well as convenience, compared to the standard testing protocol. The cost estimates presented here should prove helpful to HIV program managers and other public health decision makers who need information on these counseling and testing technologies.
Authors: Nathan M Thielman; Helen Y Chu; Jan Ostermann; Dafrosa K Itemba; Anna Mgonja; Sabina Mtweve; John A Bartlett; John F Shao; John A Crump Journal: Am J Public Health Date: 2005-11-29 Impact factor: 9.308
Authors: Robert Heimer; Lauretta E Grau; Erin Curtin; Kaveh Khoshnood; Merrill Singer Journal: Am J Public Health Date: 2006-11-30 Impact factor: 9.308
Authors: Andrea P Sitlinger; Christopher J Lindsell; Andrew H Ruffner; D Beth Wayne; Kimberly W Hart; Alexander T Trott; Carl J Fichtenbaum; Michael S Lyons Journal: Ann Emerg Med Date: 2011-07 Impact factor: 5.721
Authors: Ashley A Eggman; Daniel J Feaster; Jared A Leff; Matthew R Golden; Pedro C Castellon; Lauren Gooden; Tim Matheson; Grant N Colfax; Lisa R Metsch; Bruce R Schackman Journal: Sex Transm Dis Date: 2014-09 Impact factor: 2.830
Authors: Laura M Bogart; Devery Howerton; James Lange; Kirsten Becker; Claude Messan Setodji; Steven M Asch Journal: Public Health Rep Date: 2008 Jul-Aug Impact factor: 2.792