Impact of Expanded HIV Screening
Authors: A. David Paltiel, Rochelle P. Walensky, Kenneth A. Freedberg
Journal: Annals of Internal Medicine (2007)

Letters17 July 2007Impact of Expanded HIV ScreeningA. David Paltiel, PhD, Rochelle P. Walensky, MD, MPH, and Kenneth A. Freedberg, MD, MScA. David Paltiel, PhDFrom Yale University School of Medicine, New Haven, CT 06520, and Massachusetts General Hospital, Boston, MA 02114.Search for more papers by this author, Rochelle P. Walensky, MD, MPHFrom Yale University School of Medicine, New Haven, CT 06520, and Massachusetts General Hospital, Boston, MA 02114.Search for more papers by this author, and Kenneth A. Freedberg, MD, MScFrom Yale University School of Medicine, New Haven, CT 06520, and Massachusetts General Hospital, Boston, MA 02114.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-2-200707170-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We share Dr. Lander's concern regarding false-positive results with rapid HIV tests, especially in populations with low HIV prevalence, and we agree that guidelines for communicating findings to patients will be useful. However, we believe that his presentation of the issue is overstated. First, we deliberately accentuated the false-positive problem by adopting a conservative specificity assumption (97.5%). Today's rapid HIV tests have higher reported specificities (99.3% to 99.6%) and, therefore, have more favorable predictive values (1). Second, current approaches to screening for other chronic diseases (mammography for breast cancer, for example) suggest that diagnostic tests with high false-positive ...References1. Walensky RP, Paltiel AD. Rapid HIV testing at home: does it solve a problem or create one? Ann Intern Med. 2006;145:459-62. [PMID: 16983134] LinkGoogle Scholar2. U.S. Preventive Services Task Force. Recommendations and Rationale: Screening for Breast Cancer. Accessed at www.ahrq.gov/clinic/3rduspstf/breastcancer/brcanrr.htm on 16 January 2007. Google Scholar3. Update: HIV counseling and testing using rapid tests—United States, 1995. MMWR Morb Mortal Wkly Rep. 1998;47:211-5. [PMID: 9551881] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Yale University School of Medicine, New Haven, CT 06520, and Massachusetts General Hospital, Boston, MA 02114.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRapid HIV Testing at Home: Does It Solve a Problem or Create One? Rochelle P. Walensky and A. David Paltiel Expanded HIV Screening in the United States: Effect on Clinical Outcomes, HIV Transmission, and Costs A. David Paltiel , Rochelle P. Walensky , Bruce R. Schackman , George R. Seage III , Lauren M. Mercincavage , Milton C. Weinstein , and Kenneth A. Freedberg Impact of Expanded HIV Screening David Lander Impact of Expanded HIV Screening Hartmut B. Krentz and M. John Gill Metrics 17 July 2007Volume 147, Issue 2Page: 146-147KeywordsBreast cancerConflicts of interestHIVHIV infectionsMammographyPopulation statisticsSpecificityWestern blot ePublished: 17 July 2007 Issue Published: 17 July 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...