Premarital Testing Held Costly, Ineffective in Combatting AIDS

Mandatory AIDS tests for couples wanting to marry, a measure already endorsed by three states, would be an ineffective, inefficient and costly way to combat the deadly disease, researchers say.

“The general belief is premarital screening is inexpensive, unobtrusive and that it will have a large impact on the spread of the virus. That’s just not so,” said Paul Cleary, a researcher with the Harvard School of Public Health.

“AIDS screening is seen by too many people as a quick fix, and may in fact be a harmful distraction from the more difficult task of developing a comprehensive policy to deal with the problem,” said Cleary, one of six authors who performed a cost-benefit analysis of premarital screening.

The study is being published today in the Journal of the American Medical Assn.

The researchers estimate that 3.8 million people nationwide plan to marry each year, and the potential cost for screening, testing and counseling of them would exceed $100 million annually.

Illinois, Louisiana and Texas have enacted measures calling for some form of premarital testing by next year, and researchers noted that as of July 31, 79 bills on the subject had been introduced in 35 other states.

California recently passed a law that would require couples seeking marriage licenses to be offered AIDS testing, but would not require them to take the test.

The researchers concluded that people planning marriage have been shown to be a low-risk population for acquired immune deficiency syndrome and that premarital screening would detect fewer than 0.1% of people infected with the human immunodeficiency virus, or HIV, a precursor to AIDS in a still-undetermined percentage.

The researchers also estimated that although as many as 9,000 of the 3.8 million people screened would test positive on a screening test, only 1,200 people would show positive on a second, confirmatory test.