UMDNJ School of Public Health, 683 Hoes Lane, Piscataway, NJ 08854, USA.
J Clin Virol. 2011 Dec;52 Suppl 1:S29-33. doi: 10.1016/j.jcv.2011.09.012. Epub 2011 Nov 9.
Before 2009, New Jersey (NJ) publicly funded counseling and testing sites (CTS) tested for HIV using a single rapid test followed, when positive, by a Western Blot (WB) for confirmation. With this strategy, 74.8% of confirmed positive clients returned to receive test results. To improve the client notification rate at these centers, the New Jersey (NJ) Division of HIV, STD and TB Services (DHSTS) implemented a rapid testing algorithm (RTA) which utilizes a second, different, rapid test to verify a preliminary positive.
To compare the cost-effectiveness of the two testing algorithms.
This was a retrospective cost-effectiveness analysis.
New Jersey HIV Rapid Testing Support Program (NJHIV) records, DHSTS grant documents, counseling time estimates from an online survey of site supervisors. Costs included test kits and personnel costs from month of RTA implementation through 11/30 in 2008 and 2009. The incremental cost of the RTA was calculated per additional percent of positive clients who were notified and per day earlier notification.
In 2008, 215 of 247 clients with a positive rapid HIV test were confirmed positive by WB. 90.9% of clients were notified a mean of 11.4 days after their initial test. 12 refused confirmatory WB. In 2009, 152 of 170 clients with one positive rapid test had a confirmatory second positive rapid test and were notified on the same day. The incremental cost of the RTA was $20.31 per additional positive person notified and $24.31 per day earlier notification or $3.23 per additional positive person and $3.87 per day earlier notification if the WB were eliminated.
The RTA is a cost-effective strategy achieving 100% notification of newly HIV positive clients a mean of 11.4 days earlier compared to standard testing.
在 2009 年之前，新泽西州（NJ）的公共资金咨询和检测点（CTS）使用单一的快速检测进行 HIV 检测，阳性时再进行 Western Blot（WB）检测以确认。采用这种策略，74.8%的确诊阳性客户返回接受检测结果。为了提高这些中心的客户通知率，新泽西州（NJ）艾滋病毒、性传播疾病和结核病服务部（DHSTS）实施了一种快速检测算法（RTA），该算法使用第二种不同的快速检测来验证初步阳性结果。
比较两种检测算法的成本效益。
这是一项回顾性成本效益分析。
新泽西州 HIV 快速检测支持计划（NJHIV）记录、DHSTS 拨款文件、通过对现场主管的在线调查得出的咨询时间估算。成本包括自 RTA 实施月份到 2008 年和 2009 年 11 月 30 日的检测试剂盒和人员成本。RTA 的增量成本是根据通知的阳性客户比例增加和通知提前天数计算的。
2008 年，247 名快速 HIV 检测阳性的客户中有 215 名经 WB 确认为阳性。90.9%的客户在初次检测后平均 11.4 天得到通知。12 人拒绝进行 WB 确认。2009 年，170 名接受一种快速检测阳性的客户中有 152 名进行了第二次快速检测且结果均为阳性，并在同一天得到通知。RTA 的增量成本为每增加一名通知的阳性患者 20.31 美元，每提前一天通知增加 24.31 美元，或者如果消除 WB，则每增加一名阳性患者增加 3.23 美元，每提前一天通知增加 3.87 美元。
与标准检测相比，RTA 是一种具有成本效益的策略，可将新的 HIV 阳性客户的通知率提高 100%，平均提前 11.4 天。
