Jm. Bos et al., Cost-effectiveness of HIV screening of patients attending clinics for sexually transmitted diseases in Amsterdam, AIDS, 15(15), 2001, pp. 2031-2036
Objective: To estimate the cost-effectiveness of universal HIV screening of
patients attending a clinic for sexually transmitted diseases (STD) in Ams
terdam.
Design: Cost effectiveness analysis.
Methods: A Bernoulli model for the secondary transmission of HIV was linked
with epidemiological data on infection with HIV and other STD in patients
attending a STD clinic in Amsterdam from 1991 to 1997. This gave estimates
of the number of secondary HIV infections caused by attenders of the STD cl
inic. Combined with data on the health and monetary benefits of averting HI
V infection and costs of HIV screening, we assessed the cost-effectiveness
of HIV-screening of attenders of the STD clinic.
Results: Increased risk for HIV infection was found in STD clinic attendees
infected with other STD. (odds ratio, 2.07). The risk differed for specifi
c STD: the highest odds ratios were found for syphilis and gonorrhoea. Scre
ening of all attendees was estimated at net costs of (euro)82 552 per secon
dary infection averted. The cost-effectiveness ranges between (euro)680 and
(euro)9335 per life-year gained, depending on the value of key parameters
used in the model.
Conclusion: Compared to other interventions in infectious diseases control
in the Netherlands, screening of STD clinic attendees for HIV has an accept
able cost-effectiveness. (C) 2001 Lippincott Williams & Wilkins.