Farnham P G, Gorsky R D, Holtgrave D R, Jones W K, Guinan M E
Department of Economics, Georgia State University, Atlanta, GA 30303.
Public Health Rep. 1996 Jan-Feb;111(1):44-53; discussion 54.
New rapid human immunodeficiency virus (HIV) antibody tests permit many individuals to receive test results and appropriate counseling at one clinic visit. Because currently used tests require significant time for processing, all individuals must return for a second visit for test results and counseling. Since return rates for the second visit are low, the more rapid tests present an opportunity to improve the efficiency of HIV counseling and testing. The authors compared the costs and effectiveness of the currently used counseling and testing procedure and a streamlined procedure made possible by the new, more rapid screening tests. When test-positive clients are given preliminary screening test results, the rapid procedure is more cost-effective than the current procedure. Since over 90% of the clients in most clinics will test negative, the rapid counseling and testing procedure allows the vast majority of clients to be counseled and tested and to receive their results and posttest counseling in one visit. However, in the case where the goal of HIV counseling and testing is to focus only on infected individuals, if information regarding a positive result from the rapid screening test is not given to clients at the initial visit before a confirmatory test is performed, then the rapid counseling and testing procedure is not more cost-effective than the current procedure.
新型快速人类免疫缺陷病毒（HIV）抗体检测可让许多人在一次门诊就诊时就获得检测结果并接受适当咨询。由于目前使用的检测需要大量时间来处理，所有个体都必须再次就诊以获取检测结果和咨询。鉴于第二次就诊的回访率较低，这种更快的检测提供了提高HIV咨询和检测效率的机会。作者比较了目前使用的咨询和检测程序与由新型更快的筛查检测促成的简化程序的成本和效果。当检测呈阳性的客户获得初步筛查检测结果时，快速程序比当前程序更具成本效益。由于大多数诊所超过90%的客户检测将呈阴性，快速咨询和检测程序使绝大多数客户能够在一次就诊中接受咨询和检测，并获得检测结果及检测后咨询。然而，在HIV咨询和检测的目标仅针对受感染个体的情况下，如果在进行确认检测之前，初次就诊时不将快速筛查检测的阳性结果信息告知客户，那么快速咨询和检测程序并不比当前程序更具成本效益。
