Premarital screening for antibodies to human immunodeficiency virus type 1 in the United States. The Premarital Screening Study Group.

To evaluate premarital human immunodeficiency virus (HIV) screening as an approach to AIDS prevention in the United States, we determined the HIV antibody seroprevalence in marriage license applicants in eight areas by blinded testing of blood specimens routinely collected for syphilis serology. The seroprevalences were 0.0-0.4 percent in women and 0.0-1.1 percent in men. We also examined the impact of mandatory premarital HIV screening on marriage rates in Louisiana and Illinois. In 1988, after screening began, 9 percent and 16 percent fewer marriage licenses than in the previous two years were issued in Louisiana and Illinois, respectively. We estimated that mandatory premarital screening, if adopted nationally, would cost $167,230,000. We conclude that compared with other HIV prevention programs mandatory premarital screening would be expensive and would probably have a minor impact on the HIV epidemic.