"We're convinced based on what we've done that there needs to be more screening," said Douglas K. Owens, MD, MS, an investigator at the VA Palo Alto and associate professor of medicine at the School of Medicine's Center for Primary Care and Outcomes Research and the Center for Health Policy in the Stanford Institute for International Studies.
Owens' paper is published in the Feb. 10 issue of the New England Journal of Medicine and appears alongside another cost-effectiveness study with similar findings. "The dovetailing of these two studies is breathtaking," said A. David Paltiel, PhD, associate professor of health policy and administration at Yale and lead author of the second study. "One rarely achieves such strong, external validation of model-based results, and it really seals the deal with regard to establishing the value of expanded HIV counseling, testing and referral in the United States."
Experts have long known the importance of the timely identification of HIV. Delays in a patient's treatment can lead to irreversible immunologic damage and complications, as well as transmission of HIV through risky behavior. The Centers for Disease Control and Prevention estimates that up to 20,000 new infections annually can be attributed to people who are unaware of their HIV-positive status.
A 2003 CDC initiative recommended making voluntary testing a routine part of medical care, yet Owens said screening is still not widespread. (Money is an issue, he said, as well as disagreement among experts over whether blanket or targeted screening is more effective.) The majority of HI
Contact: Michelle Brandt
Stanford University Medical Center