LETTER
Screening Surgeons for HIV Infection
Donald S. Burke, MD, and
Arthur E. Brown, MD, MPH
15 November 1995 | Volume 123 Issue 10 | Page 812
TO THE EDITOR:
Owens and colleagues [1] conclude that counseling and testing all U.S. surgeons for human immunodeficiency virus (HIV) at a cost of $57 for each surgeon would not be a cost-effective approach for HIV control. However, the prevalence of HIV varies by more than 10-fold among U.S. states [2, 3]. We agree that routine HIV testing in low-prevalence areas does not make much sense, but we remain unconvinced that a more thoughtful, geographically targeted approach in severely affected states, districts, or cities might not be cost-effective. Furthermore, as we reported for the U.S. military [4], HIV screening programs cost less than $10 per test. The outcome of the analysis by Owens and colleagues might have been different if actual contract-negotiated costs rather than free-market, inflated cost figures had been used. We encourage Owens and colleagues to revise their cost-effectiveness model to address real costs, limited to geographic regions selected on the basis of HIV prevalence data.
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Author and Article Information
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Walter Reed Army Institute of Research; Rockville, MD 20850
1. Owens DK, Harris RA, Scott PM, Nease RF Jr. Screening surgeons for HIV infection. A cost-effectiveness analysis. Ann Intern Med. 1995; 122:641-52.
2. Burke DS, Brundage JF, Goldenbaum M, Gardner LI, Peterson M, Visintine R, et al. Human immunodeficiency virus infections in teenagers: seroprevalence among applicants for US military service. JAMA. 1990; 263:2074-7.
3. Wasser SC, Gwinn M, Fleming P. Urban-nonurban distribution of HIV infection in childbearing women in the United States. J Acquir Immune Defic Syndr. 1993; 6:1035-42.
4. Brown AE, Burke DS. Cost of HIV testing in the U.S. Army. N Engl J Med. 1995; 332:963.
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