Department of Health Services Research, Policy, and Practice, Brown University School of Public Health, South Main Street, Box G-S121-7, Providence, RI, 02903, USA.
Center for HIV/AIDS, STDs, Viral Hepatitis, and TB, Rhode Island Department of Health, 3 Capitol Hill, Providence, 02908, RI, USA.
AIDS Behav. 2018 Nov;22(11):3726-3733. doi: 10.1007/s10461-017-1940-1.
To evaluate three testing strategies to identify new HIV diagnoses in Rhode Island (RI). RI deployed three testing strategies, by using rapid HIV tests at clinical settings, community-based organization (CBO) settings, and the Partner Notification Services (PNS) program from 2012 to 2014. We reviewed the rapid HIV test results and confirmatory test results to identify new diagnoses, and conducted a cost-utility analysis. The average cost per new diagnosis was $33,015 at CBO settings, $5446 at clinical settings, and $33,818 at the PNS program. The cost-utility analysis showed the state-wide program was cost-saving; testing was cost-saving at clinical settings, and cost-effective at CBO settings and the PNS program. Further analyses showed that cost-effectiveness varied widely across CBOs. The HIV testing expansion program in RI was cost-saving overall. The heterogeneity of cost-effectiveness across settings should provide guidance to officials for allocation of future resources to HIV testing.
评估罗得岛（RI）三种检测策略以发现新的 HIV 诊断。RI 在 2012 年至 2014 年期间，在临床机构、社区组织（CBO）和伙伴通报服务（PNS）项目中，使用快速 HIV 检测，实施了三种检测策略。我们审查了快速 HIV 检测结果和确认检测结果，以确定新的诊断，并进行了成本效用分析。CBO 检测策略下每个新诊断的平均成本为 33015 美元，临床检测策略下为 5446 美元，PNS 项目下为 33818 美元。成本效用分析表明，全州范围内的项目具有成本效益；临床检测策略具有成本效益，CBO 检测策略和 PNS 项目具有成本效果。进一步的分析表明，CBO 之间的成本效益差异很大。RI 的 HIV 检测扩展计划总体上具有成本效益。不同环境下成本效益的异质性应为官员提供指导，以将未来的资源分配用于 HIV 检测。
