By comparison, routine screenings for hypertension, colon cancer and Type-2 diabetes range in cost from $48,000 to $56,000 per quality-adjusted life year.

"Our analysis indicates that screening for HIV infection is cost-effective relative to other commonly accepted screening programs and medical treatments," Sanders noted. "This finding suggests that in many health-care settings, HIV screening will provide important health benefits for a reasonable investment in health-care resources."

In the second New England Journal of Medicine study, researchers at Yale and Harvard developed a computer model of HIV screening and treatment to compare routine voluntary screening with current practice. They found that in all but the lowest-risk populations, routine and voluntary screening for HIV once every three to five years is "justified on both clinical and cost-effective grounds." The researchers concluded that "efforts to promote, finance and expand existing national HIV-testing guidelines should be pursued aggressively."

"It's exciting that a completely independent analysis had the same findings as we did," said Owens. "Both of these studies show that screening prolongs life and is affordable." Added Yale's Paltiel, "The publication of these papers represents a golden opportunity to jump-start the expansion of HIV testing services in the United States."

Now that researchers have determined that routine screening should be done, the next question to be answered is how. Owens said he's planning an analysis of different methods of screening-including newly approved, rapid testing protocols.

Owens' work was supported by the Department of Veterans Affairs, Health Services Research and Development Service, the National Institute on Drug Abuse, and the Ontario HIV Treatment Network. Co-authors on the study include Laura Lazzeroni, MS, PhD, assistant professor of heal
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Contact: Michelle Brandt
mbrandt@stanford.edu
650-723-0272
Stanford University Medical Center
9-Feb-2005