Evaluation of Yield and Cost Effectiveness Associated with 4th Generation HIV Testing

Dates: 2011-2014

Geographic Scope: Nationwide

Client(s): CDC - Centers for Disease Control and Prevention

Services: Health Care & Public Health Planning, Applied Research & Evaluation

Technical Expertise: HIV & Infectious Diseases, Population Health


HIV testing is an effective prevention strategy because people who know they are infected reduce their risk behaviors and can access treatment that may further reduce infectiousness. As 4th generation HIV testing assays detect both p24 antigen and HIV antibody, they are able to detect the virus earlier, during the period of acute HIV infection which has been implicated as an important force driving transmission and sustaining the epidemic. JSI has been contracted by CDC to evaluate 4th generation HIV screening tests in real-world settings.

JSI's role was to coordinate data collection activities for public health and clinical labs performing HIV testing using a 4th generation HIV testing assay. JSI developed a standardized data collection protocol to allow for the assessment of: 1) the cost and cost effectiveness of 4th generation HIV testing including associated supplemental HIV testing compared with historical data; 2) the yield of acute HIV infections; and 3) the proportion of reactive 4th generation immunoassays associated with false positive screening results.