School-Age and Young Adult Testing for HIV: Cost-Effectiveness Analysis to Inform Guidelines

In 2006, the CDC recommended routine HIV testing for adolescents and adults (ages 13-64) in the United States. These recommendations were based on a number of factors and studies, including the overall prevalence and undiagnosed prevalence of HIV in the United States, the availability, accuracy, rapidity, and low cost of the HIV test, as well as the availability of highly effective and life-saving therapies for HIV. Model-based analyses suggested that routine HIV testing would be very cost-effective, although these analyses did not include adolescents specifically.

The current CDC recommendations are based on a model using case surveillance among those age 13 and over. While the recommendations imply that it is worthwhile to get tested at least once in a lifetime, this recommendation is difficult to interpret early in the life course. National data highlight that HIV prevalence varies across age groups, and is much lower in teens than young and older adults. For these reasons, there is an important need to further refine the lower end of the age range for HIV testing guidelines.

This project aims to examine the yield, cost and cost-effectiveness of routine HIV testing in school-aged adolescents and young adults in the United States.