Cost-effectiveness of Frequent HIV Testing of High Risk Populations in the United States

Data showing a high incidence of HIV infection among men who have sex with men (MSM) who had annual testing suggest that more frequent HIV testing may be warranted. Testing technology is also a consideration given the availability of sensitive testing modalities as well as the increased use of less sensitive rapid, point-of-care antibody tests. We assessed the cost-effectiveness of HIV testing of MSM and injection drug users (IDUs) at 3- and 6-month intervals using fourth-generation and rapid tests.

For MSM, HIV testing was cost-saving or cost-effective over a 1-year time period for both 6-month compared to annual testing, and quarterly compared to 6-month testing using either test. Testing IDU every 6 months compared to annually was moderately cost-effective over a 1-year time period with a fourth-generation test, while testing with rapid, point-of care tests or quarterly was not cost-effective. MSM results remained robust in sensitivity analysis, while IDU results were sensitive to changes in HIV incidence and continuum-of-care parameters. Threshold analyses on costs suggested additional implementation costs could be incurred for more frequent testing for MSM while remaining cost-effective.

HIV testing of MSM as frequently as quarterly is cost-effective compared to annual testing, but testing IDU more frequently than annually is generally not cost-effective.

Via: http://ht.ly/SkieN 

By: Hutchinson AB1, Farnham PG, Sansom SL, Yaylali E, Mermin JH.

• 1Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention (CDC), Atlanta, GA.
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