The Cost-Effectiveness of Voluntary Counseling and Testing of Hospital Inpatients for HIV Infection

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Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

The Cost-Effectiveness of Voluntary Counseling and Testing of Hospital Inpatients for HIV Infection

Journal of the American Medical Association (12/21/94) Vol. 272, No. 23, P. 1832
Lurie, Peter; Avins, Andrew L.; Phillips, Kathryn A.

The Centers for Disease Control and Prevention say that HIV testing in acute care hospitals should be instituted to assist in clinical diagnosis, to permit early medical management of HIV infection, and to counsel HIV-positive patients or those at risk about methods to prevent secondary transmission to their sex partners. A study was conducted to determine the cost-effectiveness of voluntary counseling and testing of U.S. hospital inpatients for HIV. The two outcomes evaluated were: the cost per health care worker (HCW) HIV-infection prevented per year, if HCWs adopt precautions to prevent exposure from HIV-infected patients; and the cost per inpatient HIV infection detected per year. The researchers found that testing to avoid HCW infection may prevent close to four infections with HIV per year. The total program cost would be $2.7 billion, or $753 million per infection avoided. Testing to detect inpatient HIV infection would cost $16,104 per year per infection found. The researchers concluded that there was no justification for testing inpatients to prevent HIV infection of HCWs. The analysis illustrates the importance of carefully considering the purpose of HIV testing before beginning large-scale programs.

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