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The U.S. Preventive Services Task Force recommends screening people at increased risk for HIV infection (Journal Watch Jul 29 2005), but the CDC has called for a more universal approach. U.S. researchers projected the likely costs and outcomes of expanded screening in low- and moderate-prevalence populations, using a computer simulation model. Among many parameters considered were the efficacy of antiretroviral therapy, the characteristics of rapid testing, the quality-of-life impact of false-positive results, and costs for testing and clinical care.
Assuming an HIV prevalence of 1% (encountered in many health settings) and no effect of testing on transmission, one-time testing for all adults cost $37,100 per quality-adjusted life-year (QALY…