In Reply: Dr Holtgrave makes some good suggestions for a comprehensive list of metrics to obtain in the context of HIV testing, prevention, and care initiatives. Some of this work is under way. The CDC surveillance system produces estimates of the number of persons living with HIV in the United States, the proportion aware of their infection, and HIV incidence.1,2 The survival benefits of HIV treatment are well established.3 Cost-effectiveness of expanded testing has been assessed by the 3 studies cited in the Special Communication. The newly established North American HIV Database, which is part of the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) project, will permit analysis of extensive longitudinally collected data from about 75 000 patients, but this will be largely limited to clinical and laboratory data.4
Bartlett JG, Mayer KH. CDC Recommendations for Opt-Out HIV Testing—Reply. JAMA. 2009;301(3):274–276. doi:https://doi.org/10.1001/jama.2008.1009
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