Compulsory Premarital Screening for the Human Immunodeficiency Virus: Technical and Public Health Considerations

Cleary, Paul D.; Barry, Michael John; Mayer, Kenneth Hugh; Brandt, Allan M.; Gostin, Larry; Fineberg, Harvey V.

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Author

Cleary, Paul D.

Barry, Michael John HARVARD

Mayer, Kenneth Hugh HARVARD

0000-0001-7460-733X

Brandt, Allan M. HARVARD

0000-0003-1589-5700

Gostin, Larry

Fineberg, Harvey V. HARVARD

Published Version

https://doi.org/10.1001/jama.258.13.1757

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Citation

Cleary, Paul D., Michael J. Barry, Kenneth H. Mayer, Allan M. Brandt, Larry Gostin, and Harvey V. Fineberg. 1987. Compulsory premarital screening for the Human Immunodeficiency Virus: Technical and public health considerations. Journal of the American Medical Association 258(13): 1757-1762.

Abstract

The effectiveness of a mandatory premarital screening program was examined as a means of curtailing the spread of the human immunodeficiency virus (HIV) infection in the United States. The epidemiology of the HIV, the technical characteristics of tests for antibodies to HIV, and the logistic, economic, and legal implications of such a program were considered. In one year, universal premarital screening in the United States currently would detect fewer than one tenth of 1% of HIV-infected individuals at a cost of substantially more than $100 million. More than 100 infected individuals would be told that they were probably not infected, and there would likely be more than 350 false-positive results. Public education, counseling of individuals, and discretionary testing can be important tools in reducing the spread of HIV infection, but mandatory premarital screening in a population with a low prevalence of infection is a relatively ineffective and inefficient use of resources.