October 31st, 2009

Would Changing Restrictive HIV Testing Laws Improve Survival?

halloween_imageEmphatically yes — to the tune of >600,000* years of life gained nationwide.  So says a nifty paper being presented at the annual IDSA meeting today by Mike April, under the direction of Rochelle Walensky.

(*Original abstract said 549,437, cited in the link; number at the actual presentation, though, was 609,656.)

Bottom line is that laws that limit HIV testing (such as requiring written consent, ahem) lead to later diagnoses, and hence shorter projected life span for those with HIV.  As always with such models, one could quibble with certain assumptions, but the results remain robust through a wide range of sensitivity analyses.

In fact, the only way that switching to an opt-out testing policy could fail to improve survival is if opt-out discouraged a large group of people from getting tested at all — for which there’s not the slightest bit of evidence whatsoever.

Are you listening Massachusetts?  I think you are .

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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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