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HIV Screening in Primary Care Proves Cost-Effective in Areas of High Prevalence

General practitioners (GPs) may have a larger role to play in the fight against HIV and the opportunity to save hundreds of lives, according to a new study recently published in The Lancet HIV.

The authors found that introducing HIV screening in primary care offices has the potential to save lives and decrease the costs associated with treatment by increasing rates of early diagnosis. As a result of their findings, the authors are appealing to health care commissioners throughout England to include HIV screening capabilities in 74 local authorities throughout the country which are known to have a high prevalence of HIV infections (indicated as those authorities with > 2 diagnosed HIV infections per 1000 adults.)

Compared with even a decade ago, individuals who are now diagnosed with HIV can expect to have a normal life expectancy, particularly if the infection is diagnosed early and the individual starts treatment as soon as possible. However, this can only happen if an individual is aware of their status. In the United Kingdom alone, some 13,500 individuals still do not know that they are HIV+, according to a press release on the Lancet study. These individuals are missing out on treatment and will be more expensive to treat in the future.

Therefore, those involved with planning for the care of these individuals need to use reliable estimates of the cost of screening. Until the recent Lancet study, however, robust data from randomized clinical trials has not been available.

For their study, the researchers used data from a previous research trial completed in a borough in London with a high prevalence of HIV: Hackney. The rate of infection there is 8 infections per 1000 adults. Data from 40 general practices, “where they tested the effect of rapid finger-prick HIV testing as part of the standard health check during registration,” was used, according to the press release. The results showed that GP-screening led to a 4-fold higher HIV diagnosis rate. Despite the successful increase in diagnosis, the researchers needed to know if adding testing at these facilities would increase the overall cost of HIV testing and treatment.

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