Costs and Consequences of Opt-Out HIV Testing
Author Information
Author(s): David R. Holtgrave
Primary Institution: Johns Hopkins Bloomberg School of Public Health
Hypothesis
Which approach to HIV testing is more effective and cost-efficient: opt-out testing or targeted counseling and testing?
Conclusion
Targeted counseling and testing is more effective and cost-efficient than opt-out testing for diagnosing and preventing HIV infections.
Supporting Evidence
- Opt-out testing could identify 56,940 new HIV infections, while targeted testing could identify 188,170.
- Targeted counseling and testing prevents more infections at a lower cost per infection averted.
- Opt-out testing may lead to increased risky behavior due to lack of counseling.
Takeaway
This study found that testing everyone for HIV without asking questions is not as good as testing only those at high risk, because the targeted approach finds more people with HIV and prevents more infections.
Methodology
Scenario and cost-effectiveness analysis from a payer's perspective over a one-year time horizon.
Potential Biases
Assumptions made in the analysis may bias results in favor of opt-out testing.
Limitations
The study is based on predictions and assumptions, which may not hold true in real-world settings.
Participant Demographics
Focus on individuals aged 13-64 in the US.
Digital Object Identifier (DOI)
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