Cost-effectiveness of HIV screening in high-income countries: A systematic review

Bert, Fabrizio; Gualano, Maria Rosaria; Biancone, Paolo; Camussi, Elisa; Martorana, Maria Cristina; Secinaro, Silvana; Siliquini, Roberta

doi:10.1016/j.healthpol.2018.03.007

Cited by 33 publications

(24 citation statements)

References 48 publications

(432 reference statements)

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“…HIV testing in the setting of IC at baseline was low (11.2%) and although this increased to 20.5% following a single intervention, the low rate of testing following the intervention suggests that a single educational intervention is not enough to increase testing rates to an acceptable level. These results reflect what has been described by previous studies reporting low rates of HIV testing in the setting of IC despite demonstrated cost effectiveness in this setting . Many barriers to routine HIV testing stem from medical staff, including discomfort discussing HIV with patients, fears about offering testing due to a perceived lack of knowledge about HIV and lack of awareness of an individual's HIV risk, and often misguided perceptions of patients feeling offended if an HIV test is suggested .…”

Section: Discussionsupporting

confidence: 84%

“…These results reflect what has been described by previous studies reporting low rates of HIV testing in the setting of IC 14,15 despite demonstrated cost effectiveness in this setting. 11 Many barriers to routine HIV testing stem from medical staff, including discomfort discussing HIV with patients, fears about offering testing due to a perceived lack of knowledge about HIV and lack of awareness of an individual's HIV risk, and often misguided perceptions of patients feeling offended if an HIV test is suggested. 6,17,21 Additional challenges include the use of interpreters for non-English speaking culturally and linguistically diverse populations and HIV-related stigma.…”

Section: Discussionmentioning

confidence: 99%

“…Routine testing for HIV in the presence of IC has been demonstrated to be cost effective . Failure to screen for HIV when patients intersect with the healthcare system with an IC represents a missed opportunity for earlier diagnosis .…”

Section: Introductionmentioning

confidence: 99%

“…10 Routine testing for HIV in the presence of IC has been demonstrated to be cost effective. 11 Failure to screen for HIV when patients intersect with the healthcare system with an IC represents a missed opportunity for earlier diagnosis. 10,12,13 Other studies have demonstrated that among patients presenting with IC, rates of HIV testing are low.…”

Section: Introductionmentioning

confidence: 99%

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Missed opportunities for HIV testing persist despite a single educational intervention: how can we close this evidence‐practice gap?

King

Seah

Cheng

et al. 2020

Internal Medicine Journal

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Background In Australia, one‐third of human immunodeficiency virus (HIV) diagnoses occur late, with an estimated 11% of people with HIV unaware of their diagnosis. Undiagnosed and untreated HIV infection increases morbidity in the HIV positive person and allows onward transmission of HIV. Aim To determine the rate of HIV testing in acute general medicine patients with HIV indicator conditions (IC) and evaluate the effectiveness of an educational intervention in improving testing rates. Methods Single‐centre, tertiary hospital, before‐after study of general medicine inpatients with IC for 12 weeks prior and 10 weeks post an educational intervention focusing on recommendations for HIV testing including IC. The REASON Cohort Discovery Tool was used to search for the IC using ICD‐10 codes and laboratory data. The presence of IC was estimated, and HIV testing rates before and after the intervention were compared. Regression analysis was utilised to identify characteristics associated with HIV testing. Results Of 1414 admissions in the baseline period and 946 in the post‐period, 161 (11.4%) and 132 (14.0%) had at least one IC present respectively. There were 18 (11.2%) HIV tests performed for admissions with IC in the pre‐period which increased to 27 (20.5%) (P = 0.028) in the post‐period. Younger patients were more likely to be tested and regression analysis identified the educational intervention (adjusted odds ratio) 2.2 (1.1, 4.4) to be significantly associated with testing. Conclusions Although HIV testing rates for IC doubled following the intervention, they remained unacceptably low. The recently introduced electronic medical record presents opportunities to prompt HIV testing.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Missed opportunities for HIV testing persist despite a single educational intervention: how can we close this evidence‐practice gap?

King

Seah

Cheng

et al. 2020

Internal Medicine Journal

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“…Still further research seems beneficial on the cost-effectiveness analysis of routine HIV screening in dental setting. There are only a small number of published articles [34][35][36][37][38][39][40] on the cost-effectiveness of HIV screening in primary care setting. Our findings corroborate one of their suggestions: Routine HIV screening is more cost-effective in high-prevalence regions.…”

Section: Plos Onementioning

confidence: 99%

HIV screening in the dental setting in New York State

et al. 2020

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While primary care providers in New York State (NYS) are mandated to offer all patients a HIV test, still many NYS residents miss the HIV screening opportunity. To fill the gap, and as the CDC recommends, this study aimed to examine the feasibility of implementing HIV screening in dental setting, identify patient characteristics associated with acceptance of HIV rapid testing, and discuss best practices of HIV screening in dental setting. New York State Department of Health (NYSDOH) collaborated with the Northeast/Caribbean AIDS Education and Training Center (NECA AETC) and three dental schools in New York State to offer free HIV screening tests as a component of routine dental care between February 2016 and March 2018. Ten clinics in upstate New York and Long Island participated in the study. HIV screening was performed using the OraQuick™ In-Home HIV Test. 14,887 dental patients were offered HIV screening tests; 9,057 (60.8%) were screened; and one patient (0.011%) was confirmed HIV positive and linked to medical care. Of all dental patients, 33% had never been screened for HIV; and 56% had not had a primary care visit or had not been offered an HIV screening test by primary care providers in the previous 12 months. Multilevel generalized linear modeling analysis indicated that test acceptance was significantly associated with patient's age, race/ethnicity, gender, country of origin, primary payer (or insurance), past primary care visits, past HIV testing experiences, and the poverty level of patient's community. HIV screening is well accepted by dental patients and can be effectively integrated into routine dental care. HIV screening in the dental setting can be a good option for first-time testers, those who have not seen a primary care provider in the last 12 months, and those who have not been offered HIV screening at their last primary care visit.

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Risk Management and Analytical Accounting Approach in Use of the HIV Rapid Tests in the Hospital: The Case of the Amedeo di Savoia

Brescia

Tradori

Radwan

et al. 2019

The Future of Risk Management, Volume I

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Cost-effectiveness of HIV screening in high-income countries: A systematic review

Cited by 33 publications

References 48 publications

Missed opportunities for HIV testing persist despite a single educational intervention: how can we close this evidence‐practice gap?

Missed opportunities for HIV testing persist despite a single educational intervention: how can we close this evidence‐practice gap?

HIV screening in the dental setting in New York State

Risk Management and Analytical Accounting Approach in Use of the HIV Rapid Tests in the Hospital: The Case of the Amedeo di Savoia

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