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Impact of Expanded HIV Screening
- A. David Paltiel, PhD;
- Rochelle P. Walensky, MD, MPH; and
- Kenneth A. Freedberg, MD, MSc
- From Yale University School of Medicine, New Haven, CT 06520, and Massachusetts General Hospital, Boston, MA 02114.
IN RESPONSE:
We share Dr. Lander's concern regarding false-positive results with rapid HIV tests, especially in populations with low HIV prevalence, and we agree that guidelines for communicating findings to patients will be useful. However, we believe that his presentation of the issue is overstated. First, we deliberately accentuated the false-positive problem by adopting a conservative specificity assumption (97.5%). Today's rapid HIV tests have higher reported specificities (99.3% to 99.6%) and, therefore, have more favorable predictive values (1). Second, current approaches to screening for other chronic diseases …
