J Korean Med Sci.
2018 Nov;33(46):e304. 10.3346/jkms.2018.33.e304.
Cost-Effectiveness of Voluntary HIV Testing Strategies in a Very Low-Prevalence Country, the Republic of Korea
- Affiliations
-
- 1Department of Epidemiology, Seoul National University Graduate School of Public Health, Seoul, Korea.
- 2Division of Infectious Diseases, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. roundbirch@gmail.com
- 3Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 4Environmental Health Division, Seoul Metropolitan Government, Seoul, Korea.
- 5Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- KMID: 2432129
- DOI: http://doi.org/10.3346/jkms.2018.33.e304
Abstract
- BACKGROUND
The Republic of Korea has a very low prevalence of human immunodeficiency virus (HIV) infection, but the number of new HIV diagnoses has steadily risen, strongly indicating a large number of undetected HIV infections. Thus, it is important for Korean public health authorities to adopt and encourage cost-effective HIV detection tools, such as rapid HIV screening tests. In this study, we aimed to evaluate the cost-effectiveness of enzyme-linked immunosorbent assays (ELISA) and rapid tests in a public health center (PHC) setting.
METHODS
We developed a decision analytic model to assess the per-examinee cost and the cost-effectiveness of identifying HIV patients in a PHC setting using two HIV testing strategies: conventional HIV screening by ELISA versus rapid HIV testing. Analysis was performed in two scenarios: HIV testing in an average-risk population and in a high-risk population.
RESULTS
Compared to the ELISA, the rapid test was cost-saving and cost-effective. The per-examinee cost was USD 1.61 with rapid testing versus USD 3.38 with ELISA in an average-risk population, and USD 4.77 with rapid testing versus USD 7.62 with ELISA in a high-risk population. The cost of identifying a previously undiagnosed HIV case was USD 26,974 with rapid testing versus USD 42,237 with ELISA in an average-risk population, and USD 153 with rapid testing versus USD 183 with ELISA in a high-risk population.
CONCLUSION
Rapid testing would be more cost-effective than using conventional ELISA testing for identifying previously undiagnosed HIV-infected cases in Korea, a country with extremely low HIV prevalence.
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