Rotheram-Borus Mary Jane, Leibowitz Arleen A, Etzel Mark A
Department of Psychiatry and School of Public Affairs, Center for HIV Identification, Prevention, and Treatment Services, University of California, Los Angeles, 90024, USA.
AIDS Educ Prev. 2006 Jun;18(3):273-80. doi: 10.1521/aeap.2006.18.3.273.
HIV testing identifies HIV-positive persons, allowing for reduced future HIV transmission while simultaneously providing policy makers with surveillance data to inform policy planning. If current costs of HIV testing were reduced, these funds could be redirected to increase testing rates or to expand treatment. The cost of testing is lowered and impact increased if noninvasive (oral and urine), rapid-testing modalities are utilized, pretest counseling uses cost-efficient counseling methods (e.g., video, pamphlets, small group discussions), and opt-out consent strategies are implemented while posttest counseling is more narrowly targeted to HIV-positive persons. Rather than relying on one international standard, customizing HIV testing procedures to local environments may be more efficient and effective. In the United States, laboratories with substantial HIV testing revenues are likely to be most resistant to altering current practices. However, AIDS researchers, policy makers, and advocates may dramatically influence the epidemic's course by encouraging flexibility and innovation in HIV-testing guidelines.
艾滋病毒检测可识别出艾滋病毒呈阳性的人，既能减少未来的艾滋病毒传播，又能同时为政策制定者提供监测数据，以便为政策规划提供信息。如果降低目前艾滋病毒检测的成本，这些资金可以重新用于提高检测率或扩大治疗范围。如果采用非侵入性（口腔和尿液）快速检测方式，检测前咨询采用成本效益高的咨询方法（如视频、宣传册、小组讨论），实施选择退出同意策略，同时检测后咨询更有针对性地面向艾滋病毒呈阳性的人，那么检测成本就会降低，影响也会增大。与其依赖一种国际标准，根据当地环境定制艾滋病毒检测程序可能更高效、更有效。在美国，拥有大量艾滋病毒检测收入的实验室可能最抵制改变当前做法。然而，艾滋病研究人员、政策制定者和倡导者可以通过鼓励在艾滋病毒检测指南方面的灵活性和创新，极大地影响疫情的发展进程。
