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National HIV screening and testing could be very cost-effective

For four years, it’s been recommended by the federal Centers for Disease Control and Prevention that everyone between the ages of 13 and 64 be tested for HIV. But how many people really get this test? Not enough, say researchers at Stanford. And that’s one reason HIV continues to spread: 21 percent of people in this country who are infected don’t even know it, so they may be inadvertently passing it along to others, according to the CDC.

Given that, the Stanford scientists decided to look at the value of building an expanded national HIV testing and treatment program throughout the United States. In a new study, they report that screening high-risk people every year and low-risk people once in their lives would be a very cost-effective approach, preventing as many as 212,000 new infections over the next 20 years. The study came out today in the Annals of Internal Medicine.

“We find that expanded screening and treatment could offer substantial health benefits, preventing 15 to 20 percent of new cases,” Elisa Long, PhD, the study’s lead author, told me.

For the program to be most effective, people who tested positive would have to be treated with antiretroviral medications and change their risky behaviors, the researchers found. Treatment would not only prolong their lives and avoid hefty hospital bills, but also would lower the amount of virus they’re carrying so they would be less likely to transmit it to others, Douglas Owens, MD, one of the study authors, told me.

If you scale up screening but those people don’t get treatment, you don’t get as much benefit. If you scale up treatment but still have a lot of people who aren’t identified, then they aren’t going to benefit. You do the most for health outcomes by scaling up these programs together. They are synergistic.

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