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Human immunodeficiency virus partner notification. Cost and effectiveness data from an attempted randomized
K E Toomey1, T A Peterman, L W Dicker
1Divison of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Sexually Transmitted Diseases
|July 15, 1998
Summary
Partner notification for human immunodeficiency virus (HIV) is costly, with over $2,200 spent per new HIV infection identified. The study could not compare different notification methods due to group crossover, and benefits remain difficult to quantify.
Area of Science:
- Public Health
- Epidemiology
- Infectious Disease Prevention
Background:
- Partner notification is a critical component of human immunodeficiency virus (HIV) control.
- Understanding the cost-effectiveness of different HIV partner notification strategies is essential for resource allocation.
Purpose of the Study:
- To determine the cost and effectiveness of various partner notification approaches for individuals diagnosed with HIV.
- To evaluate the economic impact and yield of identifying new HIV infections through partner notification.
Main Methods:
- Individuals testing HIV positive were randomized into different partner notification groups.
- Due to significant crossover, the analysis focused on provider referral, excluding patient referral.
- Costs were calculated based on intervention specialist time, travel, and overhead.
Main Results:
- Over 1,000 index patients reported over 8,000 partners, with 122 new HIV infections identified.
- The cost per new HIV infection identified was approximately $2,200.
- No patient demographic factors reliably predicted the identification of infected partners.
Conclusions:
- Direct comparison of partner notification effectiveness was not possible due to methodological challenges (group crossover).
- While costs are quantifiable, the benefits of partner notification, such as averted infections and ethical considerations, are not easily measured.
- Further research is needed to fully assess the value and impact of HIV partner notification programs.