TY - JOUR
T1 - Human immunodeficiency virus retesting during pregnancy
T2 - Costs and effectiveness in preventing perinatal transmission
AU - Sansom, Stephanie L.
AU - Jamieson, Denise J.
AU - Farnham, Paul G.
AU - Bulterys, Marc
AU - Fowler, Mary Glenn
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2003/10/1
Y1 - 2003/10/1
N2 - OBJECTIVE: To estimate the incremental societal costs and effectiveness of a second human immunodeficiency virus (HIV) antibody test during the third trimester of pregnancy compared with no second test. METHODS: We used a decision tree in this cost-effectiveness analysis to model outcomes among pregnant women in high-risk communities and nationwide who received an initial, negative HIV antibody test during the first trimester. The main outcome measure was discounted costs per year of infant life saved. RESULTS: In high-risk communities with estimated HIV incidence of 6.2 per 1000 person-years, a second HIV test compared with no second test would detect 192 infections in women, prevent approximately 37 infant infections, and save 655 infant life-years per 100,000 women tested. Net savings would be $5.2 million. Applied to an estimated national incidence of .17 per 1000 person-years, a second test would detect 5.3 infections in women, prevent 1.3 infant infections, and save 23.3 infant life-years per 100,000 women tested. Net costs would be $1.06 million, or $45,708 for each year of infant life saved. A second test would result in net savings in populations with HIV incidence of 1.2 per 1000 person-years or higher. CONCLUSION: Health care providers serving women in communities with an HIV incidence of 1 per 1000 person-years or higher should strongly consider implementing a second voluntary universal HIV test during the third trimester. Providers serving lower-risk communities should pilot second testing to assess community-specific costs.
AB - OBJECTIVE: To estimate the incremental societal costs and effectiveness of a second human immunodeficiency virus (HIV) antibody test during the third trimester of pregnancy compared with no second test. METHODS: We used a decision tree in this cost-effectiveness analysis to model outcomes among pregnant women in high-risk communities and nationwide who received an initial, negative HIV antibody test during the first trimester. The main outcome measure was discounted costs per year of infant life saved. RESULTS: In high-risk communities with estimated HIV incidence of 6.2 per 1000 person-years, a second HIV test compared with no second test would detect 192 infections in women, prevent approximately 37 infant infections, and save 655 infant life-years per 100,000 women tested. Net savings would be $5.2 million. Applied to an estimated national incidence of .17 per 1000 person-years, a second test would detect 5.3 infections in women, prevent 1.3 infant infections, and save 23.3 infant life-years per 100,000 women tested. Net costs would be $1.06 million, or $45,708 for each year of infant life saved. A second test would result in net savings in populations with HIV incidence of 1.2 per 1000 person-years or higher. CONCLUSION: Health care providers serving women in communities with an HIV incidence of 1 per 1000 person-years or higher should strongly consider implementing a second voluntary universal HIV test during the third trimester. Providers serving lower-risk communities should pilot second testing to assess community-specific costs.
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U2 - 10.1016/S0029-7844(03)00624-0
DO - 10.1016/S0029-7844(03)00624-0
M3 - Article
C2 - 14551009
AN - SCOPUS:0141682497
SN - 0029-7844
VL - 102
SP - 782
EP - 790
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 4
ER -