Journal of Korean Medical Science

Korean Acad Medical Sciences (대한의학회)
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Cost-Effectiveness of Voluntary HIV Testing Strategies in a Very Low-Prevalence Country, the Republic of Korea

  • Lee, Young Hwa (Department of Epidemiology, Seoul National University Graduate School of Public Health) ;
  • Bang, Ji Hwan (Division of Infectious Diseases, Seoul Metropolitan Government-Seoul National University Boramae Medical Center) ;
  • Park, Sang Min (Department of Family Medicine, Seoul National University College of Medicine) ;
  • Kang, Cho Ryok (Environmental Health Division, Seoul Metropolitan Government) ;
  • Cho, Sung-Il (Department of Epidemiology, Seoul National University Graduate School of Public Health) ;
  • Oh, Myoung-don (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Lee, Jong-Koo (Department of Family Medicine, Seoul National University College of Medicine)
  • Received : 2018.04.25
  • Accepted : 2018.08.16
  • Published : 2018.11.12
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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.

Keywords

References

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