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Truth in testing.

Truth in testing

New research adds fuel to the debate about the value of widespread screening for HIV antibodies in the general population. With the rate of AIDS-causing HIV infection so low in most segments of society, critics argue that the low but persistent rate of false positive results inherent in the screening test makes large-scale screening more trouble than it's worth. It would be far more efficient, they say, to test only populations known to be at high risk.

Much of the debate hinges on one critical question: Just how high is the rate of false positives using the antibody tests available today? One answer comes from the U.S. military, where applicants are routinely screened for HIV infection. In a study described in the Oct. 13 NEW ENGLAND JOURNAL OF MEDICINE, 135,187 military applicants from rural counties in states with a low incience of AIDS were tested for HIV antibodies. Using extremely stringent criteria developed by the Army-- which included three different backup tests to confirm any inital positives -- the screening program came up with only one false positive.

The researchers, led by Donald S. Burke of the Walter Reed Army Institute of Research in Washington, D.C., conclude that "a screening program for HIV infection in a low-prevalence population can have an acceptably low false positive rate."

They acknowledge that lower test volume and different rules for test interpretation in civilian programs might well result in higher levels of false positives.

The cost of testing was about $19 per person, one of the researchers told SCIENCE NEWS. Critics of widespread or mandatory testing contend the real costs of screening -- and counseling -- civilians may be much higher, and that a low false positive rate alone should not determine public policy.
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Title Annotation:HIV testing
Publication:Science News
Date:Oct 15, 1988
Previous Article:HIV: more tricks up its sleeve.
Next Article:'Human factors' and military decisions.

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