To the Editor.
—The analysis of cost-effectiveness and cost efficiency of mass premarital screening for human immunodeficiency virus (HIV) by Cleary et al1 and the letters to the editor in response to it2 left out a major factor. There was no discussion of what should be done to prevent the asymptomatic HIV-positive individual from transmitting HIV. In the table included with the letters to the editor2 the last column is labeled "Cost per Prevention. " I know of no studies to show that screening populations, premaritally or otherwise, leads to prevention of infection with HIV.In convincing our state legislature that there is little value in mass screening of any kind and in preparing for meetings with a select committee of the legislature to study major acquired immunodeficiency syndrome issues, it would be helpful if authors of articles that could have an impact on policy-making would state their
Buttery CMG. Premarital Screening for HIV. JAMA. 1988;259(21):3127-3128. doi:10.1001/jama.1988.03720210017013