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Voluntary screening program for HIV in pregnancy. Cost effectiveness.

M E Rivera-Alsina1, C C Rivera, N Rollene

  • 1Department of Obstetrics and Gynecology, Naval Medical Center, San Diego, California, USA.

The Journal of Reproductive Medicine
|April 18, 2001
PubMed
Summary

A voluntary human immunodeficiency virus (HIV) screening program in pregnancy found zero cases of HIV. This voluntary HIV testing in pregnant individuals was effective and showed a lower prevalence than expected.

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Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Health Economics

Background:

  • Voluntary human immunodeficiency virus (HIV) screening in pregnancy is a key strategy for preventing mother-to-child transmission.
  • Understanding the effectiveness and cost-benefit of such programs is crucial for resource allocation and public health policy.
  • Previous data indicated a national pregnancy prevalence of HIV, necessitating evaluation of localized screening programs.

Purpose of the Study:

  • To assess the effectiveness of a voluntary HIV screening program implemented in a military healthcare setting.
  • To analyze the outcomes and costs associated with voluntary HIV testing versus non-testing decisions in pregnant individuals.
  • To compare the observed HIV seroprevalence in the study population with national and military prevalence rates.

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Main Methods:

  • A business decision theory analysis model was employed to estimate outcomes and costs.
  • Patient decisions regarding HIV testing (test/no test) were analyzed.
  • Data from the Naval Medical Center San Diego Program between 1995 and 1997 were utilized.

Main Results:

  • A total of 11,925 pregnant individuals were screened for HIV between 1995 and 1997.
  • The incidence of HIV seroprevalence among screened patients was zero.
  • The prevalence of HIV in active duty Navy personnel ranged from 0.022% to 0.028% during the study period.
  • The number of patients declining HIV screening was minimal, with only 23 individuals opting out over three years.

Conclusions:

  • The voluntary HIV screening program demonstrated zero HIV seroprevalence in the pregnant population studied, which was lower than anticipated.
  • The program's cost was $103,748 for the study period, significantly less than the potential cost of caring for one HIV-positive neonate ($100,000-$200,000).
  • The findings suggest that voluntary HIV screening in this pregnant population is effective and potentially cost-saving.