ArticlePLoS medicine2010
Cost-effectiveness of pooled nucleic acid amplification testing for acute HIV infection after third-generation HIV antibody screening and rapid testing in the United States: a comparison of three public health settings.
Article in PLoS medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Incorporation of Social Determinants of Health in the Peer-Reviewed Literature: A Systematic Review of Articles Authored by the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.Public health reports (Washington, D.C. : 1974)Pooled it
- A Four-Item Risk Score to Target Acute HIV Infection Testing Among Men Who Have Sex With Men in Indonesia: Development and Validation in the INTERACT Prospective Cohort.Journal of the International AIDS Society · 2026Article
- Cost-effectiveness of frequent HIV screening among men who have sex with men in China.BMC public health · 2025Article
- Financing Benefits and Barriers to Routine HIV Screening in Clinical Settings in the United States: A Scoping Review.International journal of environmental research and public health · 2022Article
- Cost-Effectiveness of Pre-Exposure Prophylaxis Among Adolescent Sexual Minority Males.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2020Article
- Randomized Controlled Pilot Study of Antiretrovirals and a Behavioral Intervention for Persons With Acute HIV Infection: Opportunity for Interrupting Transmission.Open forum infectious diseases · 2019Article
- Determination of Varying Group Sizes for Pooling Procedure.Computational and mathematical methods in medicine · 2019Article
- Evidence for optimal HIV screening and testing intervals in HIV-negative individuals from various risk groups: A systematic review.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2018Article
- Universal Rapid Human Immunodeficiency Virus Screening at Delivery: A Cost-Effectiveness Analysis.Infectious diseases in obstetrics and gynecology · 2018Article
- Clinical and public health implications of acute and early HIV detection and treatment: a scoping review.Journal of the International AIDS Society · 2017Article
- Screening for acute HIV infection in community-based settings: Cost-effectiveness and impact on transmissions.The Journal of infection · 2016Article
- Cost-Effectiveness of Frequent HIV Testing of High-Risk Populations in the United States.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- Incorporating Acute HIV Screening into Routine HIV Testing at Sexually Transmitted Infection Clinics, and HIV Testing and Counseling Centers in Lilongwe, Malawi.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- Using a Multitest Algorithm to Improve the Positive Predictive Value of Rapid HIV Testing and Linkage to HIV Care in Nonclinical HIV Test Sites.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- The HIV treatment cascade in acutely infected people: informing global guidelines.Current opinion in HIV and AIDS · 2015Review
- Enhanced Sensitivity for Detection of HIV-1 p24 Antigen by a Novel Nuclease-Linked Fluorescence Oligonucleotide Assay.PloS one · 2015Article
- Syringe exchange in the United States: a national level economic evaluation of hypothetical increases in investment.AIDS and behavior · 2014Article
- Evaluating New Definitions of Acute and Early HIV Infection from HIV Surveillance Data.The open AIDS journal · 2014Article
- Finding those at risk: acute HIV infection in Newark, NJ.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2013Article
- Targeting screening and social marketing to increase detection of acute HIV infection in men who have sex with men in Vancouver, British Columbia.AIDS (London, England) · 2013Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDetection of acute HIV infection (AHI) with pooled nucleic acid amplification testing (NAAT) following HIV testing is feasible. However, cost-effectiveness analyses to guide policy around AHI screening are lacking; particularly after more sensitive third-generation antibody screening and rapid testing. METHODS AND
findingsWe conducted a cost-effectiveness analysis of pooled NAAT screening that assessed the prevention benefits of identification and notification of persons with AHI and cases averted compared with repeat antibody testing at different intervals. Effectiveness data were derived from a Centers for Disease Control and Prevention AHI study conducted in three settings: municipal sexually transmitted disease (STD) clinics, a community clinic serving a population of men who have sex with men, and HIV counseling and testing sites. Our analysis included a micro-costing study of NAAT and a mathematical model of HIV transmission. Cost-effectiveness ratios are reported as costs per quality-adjusted life year (QALY) gained in US dollars from the societal perspective. Sensitivity analyses were conducted on key variables, including AHI positivity rates, antibody testing frequency, symptomatic detection of AHI, and costs. Pooled NAAT for AHI screening following annual antibody testing had cost-effectiveness ratios exceeding US$200,000 per QALY gained for the municipal STD clinics and HIV counseling and testing sites and was cost saving for the community clinic. Cost-effectiveness ratios increased substantially if the antibody testing interval decreased to every 6 months and decreased to cost-saving if the testing interval increased to every 5 years. NAAT was cost saving in the community clinic in all situations. Results were particularly sensitive to AHI screening yield.
conclusionsPooled NAAT screening for AHI following negative third-generation antibody or rapid tests is not cost-effective at recommended antibody testing intervals for high-risk persons except in very high-incidence settings.
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Registered trials
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