PMID: 9556471Dec 16, 1998Paper

A decision analysis of mandatory compared with voluntary HIV testing in pregnant women

Annals of Internal Medicine
I A NakchbandiD G Smith

Abstract

The benefit of antiretroviral therapy in reducing maternal-fetal transmission of HIV during pregnancy has caused a public policy debate about the relative benefits of mandatory HIV screening and voluntary HIV screening in pregnant women. To evaluate the benefits and risks of mandatory compared with voluntary HIV testing of pregnant women to help guide research and policy. A decision analysis that incorporated the following variables: acceptance and benefit of prenatal care, acceptance and benefit of zidovudine therapy in HIV-infected women, prevalence of HIV infection, and mandatory compared with voluntary HIV testing. The threshold deterrence rate (defined as the percentage of women who, if deterred from seeking prenatal care because of a mandatory HIV testing policy, would offset the benefit of zidovudine in reducing vertical HIV transmission) and the difference between a policy of mandatory testing and a policy of voluntary testing in the absolute number of HIV-infected infants or dead infants. Voluntary HIV testing was preferred over a broad range of values in the model. At baseline, the threshold deterrence rate was 0.4%. At a deterrence rate of 0.5%, the number of infants (n = 167) spared HIV infection annually in the Uni...Continue Reading

Citations

Sep 28, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Anna Wald, Rhoda Ashley-Morrow
Sep 19, 2007·European Journal of Public Health·Jessika DeblondeMarleen Temmerman
Mar 21, 2001·Journal of Acquired Immune Deficiency Syndromes : JAIDS·T SummersT Coates
Sep 30, 2000·PharmacoEconomics·A E AdesM J Sculpher
Jun 1, 2007·American Journal of Public Health·Udo Schuklenk, Anita Kleinsmidt
May 1, 2007·The American Journal of Medicine·Joshua N BressTimothy R Sterling
Oct 22, 2003·Revista de saúde pública·Marcelo Zubaran GoldaniAndrew Tomkins
Jul 9, 2010·The Cochrane Database of Systematic Reviews·Moses BateganyaSusan M Kiene
Mar 5, 2008·Developing World Bioethics·Russell Armstrong

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