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Study finds payoff in wider HIV testing

Medicine@Yale, 2005 - June July


One of the deadliest features of the human immunodeficiency virus (HIV; micrograph at right) is its insidiousness. Those infected often live for years without obvious symptoms, unwittingly passing the virus on to others while their own immune systems steadily weaken. Public health experts estimate that nearly a third of the 900,000 Americans infected with HIV are unaware that they carry the virus.

The Centers for Disease Control and Prevention recommends regular HIV testing for high-risk groups with infection rates of 1 percent or more, but A. David Paltiel, Ph.D., of the Department of Epidemiology and Public Health wondered whether the United States could cost-effectively expand testing to include groups at lower risk.

To find out, Paltiel and Boston-based colleagues devised a mathematical model, and as reported in The New England Journal of Medicine, they found that expanding HIV testing to all but the lowest-risk groups would be well worth the additional cost, and would have a greater survival benefit for every dollar spent than other currently routine screenings, such as those for breast cancer, high blood pressure and diabetes.

According to Paltiel, the findings present “a golden opportunity to jumpstart the expansion of HIV testing services in the United States.”