Free Tests Cheaper than Charging in Preventing AIDS

Surface of a lymphocyte affected
with HIV-1; © PHIL

The results were recorded at a Duke University Medical Center study conducted in Tanzania. The researchers provided free HIV tests and counselling during a two-week pilot program. The number of people seeking tests increased from 4.1 per day to 15.0 per day during the pilot program. However, the number decreased to 7.1 people per day after the small fee was reinstated. When only four people per day were tested at the clinic, it cost $170 to avert an HIV infection, the study showed. But when the testing rate jumped to 15 people per day, the price of preventing an HIV infection dropped to $92 each, even without the revenue from fees. The cost includes everything required to run a testing program – staff salaries, laboratory supplies and test kits, utilities and office supplies.

"I think there is an important policy message here," said Nathan Thielman, M.D., an associate professor of infectious diseases and medicine at Duke University Medical Center. "Providing free HIV tests increases the number of clients presenting for evaluation and makes HIV prevention more cost-effective. We changed our practice because of these results," he said.

"People want to know if they are infected," said senior study author John Crump, M.D., a Duke assistant professor of medicine who works full-time at the Kilimanjaro Christian Medical Centre in Tanzania. "One reason is because there is much greater access now to antiretroviral therapy."

Thielman acknowledges that the cost of free testing is a significant factor for organisations with limited resources. "Cost is probably the biggest barrier, but if the goal is to prevent HIV infection, free testing and counselling provides outstanding bang for your buck," he said.; Source: Duke University