A recent study by researchers at Weill Cornell Medical College has revealed the cost-effectiveness of integrating on-site rapid HIV testing at drug treatment centers. Currently, less than half of all community based drug treatment programs in the United States test their patients for HIV test on- site. The results of the study were published in this month’s issue of Drug and Alcohol Dependence.
The research cited a similar study conducted by the National Drug Abuse Clinical Trials Network, which appeared in June’s issue of the American Journal of Public Health. This research randomly selected twelve community based drug treatment programs to participate in the study. Of these twelve drug treatment centers, 80 percent offered on-site HIV testing and obtained test results, and less than 20 percent of the drug treatment programs tested off-site for HIV and did not obtain test results.
The most recent study conducted by Cornell utilized data compiled from this National Drug Abuse Clinical Trials Network study, such as patient demographics, previous testing history, test acceptance and receipt of results, undiagnosed HIV prevalence and program costs. The Cornell study measured cost-effectiveness of on-site rapid HIV testing in community based drug treatment centers. A computer simulation program was used to project life expectancy and the lifetime costs of treating a drug treatment program patient for AIDS, should the results come back positive. The study examined the cost per quality adjusted life years(QALY) for HIV positive patients with and without on-site testing. They also calculated the costs as they related to patients who are not HIV positive.
The research complies with President Obama’s National HIV/AIDS strategy. Lead researcher Dr. Bruce R. Schackman, associate professor of public health at Weill Cornell Medical College states, “We found that on-site testing with a description of the testing procedure, without pre-test risk-reduction counseling, resulted in a beneficial cost-effectiveness ratio. This strategy provides better value than off-site referral.”
The results of the research showed a cost effectiveness quotient of $60,300 per QALY. This figure is below the $100,000 acceptable QALY currently used in the United States.
Furthermore, the study proved that risk reduction counseling for patients is not a good value for community based drug treatment programs. The cost per patient for risk reduction counseling increases the cost by almost 90 percent. However, the risk reduction counseling had no effect on the drug treatment center patients’ reported sexual behaviors. Therefore, risk reduction counseling appeared to be a waste of funds.
HIV cases in the United States have been steady over the past 15 years. New medical advances have made treating the illness more manageable, but over 20 percent of people infected with HIV are unaware that they have the disease. Therefore, they remain untreated. Of course, being unaware of having HIV, this 20 percent infected population is more likely to have a reduction in life span and remains likely to spread the disease to others.
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