PubMed · 9170746
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1997. CDA approves HIV testing guidelines.. https://pubmed.ncbi.nlm.nih.gov/9170746/
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BACKGROUND: HIV testing, with appropriate counseling, can help prevent the spread of HIV infection. This study is the first national survey in Italy that examines factors associated with serotesting among Italian heterosexuals and is part of a European Concerted Action. METHODS: In 1998, a cross-sectional telephone survey was conducted on a random sample (n = 2,603) of the Italian population ages 18-49 years. Associations between HIV testing and risky sexual behaviors (multiple sexual partners in the past 5 years, intercourse with prostitutes, not always using condoms with a new sexual partner) and sociodemographic variables are examined separately for men and women using multiple logistic regression. RESULTS: The prevalence of having ever been tested for HIV, whether voluntarily or not, among heterosexual men and women is 27.0 and 32.8%, respectively. Voluntary testing is reported by 8.4% of heterosexual men and 6.1% of heterosexual women. Multivariate analysis shows that having multiple sexual partners significantly increases the odds of testing (Men: OR = 2.10; 95% CI: 1.3-3.4. Women: OR = 3.03; 95% CI: 1.7-5.4). Multiple logistic regression, controlling for risky behavior, shows also that persons ages 30-39 years have significantly higher probability of being tested than younger subjects (Men: OR = 3.30; 95% CI: 1.4-7.9. Women: OR = 2.61; 95% CI:1.1-6.4). Better educated women tend to have a higher probability of testing, but this increase is not significant at the 5% level. CONCLUSIONS: The prevalence of voluntary serotesting in Italy is lower than in other countries. Risky sexual behavior is associated with higher odds of testing; however, a high proportion of at-risk heterosexuals never sought testing. Particular attention should be dedicated to younger persons and to less educated women.
OBJECTIVE: To evaluate the cost effectiveness of voluntary prenatal and routine postnatal HIV screening in the cohort of pregnant women and newborns in the United States. DESIGN: Cost-effectiveness analysis. We developed a decision model to analyze the cost effectiveness of enhanced prenatal screening and routine newborn screening for HIV. We also analyzed the incremental cost effectiveness of routine newborn screening when improved voluntary prenatal screening is already in place. PARTICIPANTS: Analysis of the cohort of pregnant women and newborns in the United States. INTERVENTIONS: Enhanced prenatal screening, or routine newborn screening for HIV. MAIN OUTCOME MEASURES: Infections averted, life expectancy, costs, and incremental cost effectiveness. RESULTS: Improved participation in voluntary prenatal HIV screening would result in an additional 1.1 million women being screened annually, would identify an additional 527 HIV-infected mothers annually, would avert 150 infections in newborns, and would cost $8,900 U.S. per life-year gained. Routine newborn HIV screening would test 3.9 million infants annually, would identify 1061 HIV-infected mothers, would avert 266 infections in newborns, and would cost $7,000 U.S. per life-year gained. If improved voluntary prenatal screening is already in place, routine newborn screening would avert an additional 135 infections in newborns, at an incremental cost of $10, 600 U.S. per life-year gained. The screening programs are likely to be cost effective over a wide range of assumptions regarding key factors in the analysis. CONCLUSIONS: Improved voluntary prenatal HIV screening of women and routine screening of newborns are cost effective. Routine newborn screening becomes less attractive as the rate of voluntary prenatal screening increases. Improved participation in voluntary prenatal screening has the added benefit that mothers maintain their right to determine whether they are tested for HIV.
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