Cost comparison of three HIV counseling and testing technologies

Donatus U. Ekwueme, Steven D. Pinkerton, David R Holtgrave, Bernard M. Branson

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)112-121
Number of pages10
JournalAmerican Journal of Preventive Medicine
Volume25
Issue number2
DOIs
StatePublished - Aug 2003
Externally publishedYes

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Counseling
HIV
Technology
Costs and Cost Analysis
Economics
HIV-2
Seroepidemiologic Studies
Exercise Test
Uncertainty
Public Health
Antibodies

ASJC Scopus subject areas

  • Medicine(all)
  • Public Health, Environmental and Occupational Health

Cite this

Cost comparison of three HIV counseling and testing technologies. / Ekwueme, Donatus U.; Pinkerton, Steven D.; Holtgrave, David R; Branson, Bernard M.

In: American Journal of Preventive Medicine, Vol. 25, No. 2, 08.2003, p. 112-121.

Research output: Contribution to journalArticle

Ekwueme, Donatus U. ; Pinkerton, Steven D. ; Holtgrave, David R ; Branson, Bernard M. / Cost comparison of three HIV counseling and testing technologies. In: American Journal of Preventive Medicine. 2003 ; Vol. 25, No. 2. pp. 112-121.
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