COUNSELING AND TESTING FOR HIV PREVENTION - COSTS, EFFECTS, AND COST-EFFECTIVENESS OF MORE RAPID SCREENING-TESTS

NEW RAPID HUMAN immunodeficiency virus (HIV) antibody tests permit man y individuals to receive test results and appropriate counseling at on e clinic visit. Because currently used tests require significant time for processing, all individuals must return for a second visit for tes t results and counseling Since re-rum rates for the second visit are l ow, the more rapid tests present an opportunity to improve the efficie ncy of HIV counseling and testing. The authors compared the costs and effectiveness of the currently used counseling and testing procedure a nd a streamlined procedure made possible by the new, more rapid screen ing tests. When test-positive clients are given preliminary screening test results, the rapid procedure is more cost-effective than the curr ent procedure. Since over 90% of the clients in most clinics will test negative, the rapid counseling and testing procedure allows the vast majority of clients to be counseled and tested and to receive their re sults and posttest counseling in one visit. However, in the case where the goal of HIV counseling and testing is to focus only on infected i ndividuals if information regarding a positive result from the rapid s creening test is not given to clients at the initial visit before a co nfirmatory test is performed, then the rapid counseling and testing pr ocedure is not more cost-effective than the current procedure.