Cost-Benefit Study Finds HIV Testing Too Infrequent

That HIV testing is important, everyone seems to know. But how regularly should people at different risk levels have the test repeated? Both patients and doctors seem confused about this point, Aaron Lucas discovered during the course of a cost-effectiveness study of HIV testing intervals. The conclusion was for optimal use of public health dollars, not to mention the safety of the public, HIV testing should be done more frequently. Learn the details in this 5-minute recorded interview.

Aaron Lucas is a PhD candidate in the Department of Industrial Engineering and Management Sciences at Northwestern University in Evanston IL.

Cost-Benefit Study Finds HIV Testing Too Infrequent

The questions:

•  Tell us why someone who is working in the area of industrial engineering has gotten involved in a study about HIV testing.

•  Tell me about the desision to focus in on HIV testing as a health care intervention.

•  I'm not going to ask you to explain the mathematical modeling you used! But I am going to ask you to tell us what the results showed and then talk a bit about what the implications are on a policy basis and on a clinical basis.

•  Basically what you're saying is that for anyone other than those who are really low risk the testing should be more frequent?

•  When you were looking at this you also figured into your equation assuming that people who tested positive would immediately begin on ART. Is that correct?

•  Do these findings have any implications at the clinical level for the physicians who are listening to this?

•  So perhaps if a physician is asked, how often should I be tested, could say, Well technically the guidelines say for someone at your risk once a year or once in a lifetime but we just saw this study that said it might be more effective if you were tested every 3 years. Let's make an appointment.

Key quotes:

•  I worked in an HIV clinic and a lot of people approached me wondering how often they should come back for HIV testing. A lot of physicians ... are not quite sure how often the patients should come back to get tested.

•  The CDC recommendations right now ... are too conservative.

•  Our policy is sort of a futuristic policy and it's one that we see HIV testing moving towards.

•  We feel that physicians should be more active in recommending how often people should be tested for HIV, not just recommending a test.

Reference:

Aaron Lucas and Benjamin Armbruster. The cost-effectiveness of expanded HIV screening in the United States. AIDS (2013) 27:795–801