There isn't enough knowledge about the prevalence of HIV infection to justify mandatory testing of all healthcare workers, a new study indicates.
The study by researchers at the University of California-San Francisco Medical School showed a difference of more than $90 million in whether it would save or cost money for healthcare providers to test their workers for HIV, the virus that causes AIDS.
"We simply don't know what the prevalence of HIV infection is," said Kathryn Phillips of the Center for AIDS Prevention at the University of California-San Francisco Medical School. "Prevalence of HIV and AIDS could vary, and does, from region to region."
If the rate of infection among the nation's 132,000 surgeons were low, the net cost to the country of testing them all would be nearly $90 million, the researchers said. On the other hand, if the infection rate were high, the average net savings for every case of HIV infection avoided would be $6,000, the study said.
"Mandatory testing shouldn't be implemented without further study," Ms. Phillips said. "You have to consider the ethical, social and public health implications of all this before anybody implements a testing policy. Testing has a lot of implications, and there's the potential for discrimination among other things."
An HIV test costs an average $54 per person if the healthcare worker tests negative for HIV. But if the worker tests positive, it would cost $147 because of two additional blood tests and counseling, UCSF researchers said.
"More information is needed on the HIV seroprevalence of surgeons and dentists, transmission risk and the cost-effectiveness of methods to reduce risk," UCSF researchers wrote in the study, which was sponsored by the National Institute of Mental Health, National Institutes of Health and HHS' Agency for Health Care Policy and Research.
Results of the research were published in the March 16 Journal of the American Medical Association.