Rapid HIV tests offer economic advantages and convenience

A cost comparison of three HIV testing technologies, conducted by researchers at the US Centres for Disease Control and Prevention and other institutions, concludes that rapid test protocols offer economic advantages as well as convenience, compared to the standard testing protocol. Donatus U Ekwueme and colleagues present cost estimates that should prove helpful to HIV programme managers and other public health decision makers who need information on these counselling and testing technologies.

More than 2 million HIV tests are performed each year at publicly funded clinics in the US. Clients do not receive results of one third of these tests because they don’t go back to the clinic for them. Results of standard tests can take up to two weeks, but the use of newer, rapid tests improves the number of people who learn their test results. The researchers write that no study has systematically compared the costs of these newer technologies with standard tests so they compared three HIV counselling and testing protocols: the standard protocol and the one-step and two-step rapid protocols.

They calculated the intervention costs of counselling and testing services with each type of protocol and found that the one-step rapid protocol was generally the least expensive of the three. They also report: “The standard protocol cost less than the two-step protocol per HIV-positive client notified of his or her HIV status, but cost more per HIV-negative client. The sensitivity analysis indicated overlap in the cost estimates for HIV-negative clients, reflecting the generally similar costs of the three testing protocols. Taking into account HIV seroprevalence, the two-step rapid protocol would be less expensive than the standard protocol for most publicly funded testing programs in the United States.”