The Centers for Disease Control and Prevention wants to spend the equivalent of $864 million a year getting everyone between ages 13 and 64 tested for AIDS at every doctor visit.
Johns Hopkins researchers estimate this strategy would identify one-third as many positive cases and preventone-fourth the new infections as targeting high-risk populations.
“We?re actually considering targeting particular types of clinics where people without access to health care might go,” including emergency rooms and urgent care centers, said David Holtgrave, professor and chair of the Bloomberg School?s Department of Health, Behavior and Society. He also recommends focusing on cities with high AIDS populations, such as Baltimore and Miami, and on STD clinics and routine risk screening in regular clinics.
His findings are published in the June edition of journal Public Library of Science Medicine.
The CDC estimates one in four people with HIV infections doesn?t know it. The agency recommends cutting costs and time by eliminating risk counseling but allowing patients to refuse testing.
Spending that money on targeted testing would diagnose 188,170 new HIV infections in a year, the Bloomberg study found, compared with 56,940 through the CDC plan.
Combining risk counseling with targeted testing would prevent an estimated 14,553 new HIV infections at a cost of $59,383 per infection prevented, compared with 3,644 saves through opt-out testing at $237,149 per prevention, Holtgrave found.
