Mandatory premarital testing for human immunodeficiency virus. The Illinois experience

Area of Science:

• Public Health
• Epidemiology
• Health Policy

Background:

• Legislative mandates for human immunodeficiency virus (HIV) testing are implemented to control infection spread.
• Evaluating the effectiveness and cost-efficiency of public health interventions is crucial.

Purpose of the Study:

• To assess the cost-effectiveness of mandatory premarital human immunodeficiency virus (HIV) testing in Illinois.
• To analyze the impact of the testing mandate on HIV seroprevalence and marriage license issuance.

Main Methods:

• Analysis of data from the first six months of mandatory premarital HIV testing in Illinois.
• Calculation of seroprevalence rates and program costs.
• Comparison of marriage license application numbers before and after the mandate.

Main Results:

• A low seroprevalence of 0.011% (8 out of 70,846) for HIV was detected.
• The estimated cost per identified seropositive individual was $312,000.
• A 22.5% decrease in marriage licenses issued in Illinois was observed, with an increase in residents seeking licenses in neighboring states.

Conclusions:

• Mandatory premarital HIV testing in Illinois is not a cost-effective strategy for HIV infection control.
• The policy may have unintended consequences, such as discouraging in-state marriages.