Is Point of Care Rapid-HIV Testing in New York City School-Based Health Centers Worthwhile? An Analysis of Cost, Benefit and Utility
Date
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
YU Faculty Profile
Abstract
Montefiore Medical Center provides medical care through 20 school-based health centers, serving 56 New York City public schools in the Bronx. Amongst these are 13 school campuses participating in the Point of Care Testing (POCT) Rapid-HIV program. This analysis determines the cost, benefit and utility of the POCT OraQuick Advance HIV-1/2 Rapid Antibody Testing (HIV-R) as compared to standard in lab testing (HIV-IL) in the New York City public school system. Pre-analytic, analytic and post-analytic variables were considered. The cost effectiveness of HIV-R as compared to HIV-IL was found to be dependent upon the personnel performing and reviewing the test, volume of tests/month, and amount of time spent reviewing results. When testing volume exceeded an average 20 tests/month, HIV-R was more cost effective. Students received their HIV-R results within 27.3 min, but could wait several days to receive their HIV-IL results due to scheduling issues. According to the EMR Database, 69.9% of students receiving HIV-R testing came in for reproductive health reasons or HIV/STI screening. Additionally, 66% of those tested were female and 34% male. Providers reported a dramatic increase in consent rates when switching to HIV-R, with many students consenting when learning of the test’s non-invasive nature.