The Cost of Implementing Rapid HIV Testing in Sexually Transmitted Disease Clinics in the United States

INTRODUCTIONRapid HIV testing in high-risk populations can increase the number of persons who learn their HIV status and avoid spending clinic resources to locate persons identified as HIV infected. METHODSWe determined the cost to sexually transmitted disease (STD) clinics of point-of-care rapid HI...

Full description

Saved in:
Bibliographic Details
Published in:Sexually transmitted diseases 2014-09, Vol.41 (9), p.545-550
Main Authors: Eggman, Ashley A., Feaster, Daniel J., Leff, Jared A., Golden, Matthew R., Castellon, Pedro C., Gooden, Lauren, Matheson, Tim, Colfax, Grant N., Metsch, Lisa R., Schackman, Bruce R.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Ambulatory Care Facilities - economics
Ambulatory Care Facilities - organization & administration
Clinical trials
Cost-Benefit Analysis
Delivery of Health Care
Diagnostic tests
Direct Service Costs
Directive Counseling - economics
Directive Counseling - organization & administration
Female
Gynecology
HIV
HIV Seropositivity - diagnosis
HIV Seropositivity - economics
Human immunodeficiency virus
Humans
Male
Mass Screening - economics
Middle Aged
Original Study
Point-of-Care Systems - economics
Point-of-Care Systems - organization & administration
Practice Patterns, Nurses' - economics
Practice Patterns, Nurses' - organization & administration
Reagent Kits, Diagnostic - economics
Sexually transmitted diseases
STD
United States
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:INTRODUCTIONRapid HIV testing in high-risk populations can increase the number of persons who learn their HIV status and avoid spending clinic resources to locate persons identified as HIV infected. METHODSWe determined the cost to sexually transmitted disease (STD) clinics of point-of-care rapid HIV testing using data from 7 public clinics that participated in a randomized trial of rapid testing with and without brief patient-centered risk reduction counseling in 2010. Costs included counselor and trainer time, supplies, and clinic overhead. We applied national labor rates and test costs. We calculated median clinic start-up costs and mean cost per patient tested, and projected incremental annual costs of implementing universal rapid HIV testing compared with current testing practices. RESULTSCriteria for offering rapid HIV testing and methods for delivering nonrapid test results varied among clinics before the trial. Rapid HIV testing cost an average of US$22/patient without brief risk reduction counseling and US$46/patient with counseling in these 7 clinics. Median start-up costs per clinic were US$1100 and US$16,100 without and with counseling, respectively. Estimated incremental annual costs per clinic of implementing universal rapid HIV testing varied by whether or not brief counseling is conducted and by current clinic testing practices, ranging from a savings of US$19,500 to a cost of US$40,700 without counseling and a cost of US$98,000 to US$153,900 with counseling. CONCLUSIONSUniversal rapid HIV testing in STD clinics with same-day results can be implemented at relatively low cost to STD clinics, if brief risk reduction counseling is not offered.
ISSN:0148-5717
1537-4521
DOI:10.1097/OLQ.0000000000000168