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April 21, 1989

Premarital HIV Screening-Reply

JAMA. 1989;261(15):2198. doi:10.1001/jama.1989.03420150048017

In Reply. —  We agree with Dr Mercola that the cost of identifying a person with human immunodeficiency virus (HIV) infection is currently lower than our original estimate, although variations in the cost of testing limit the accuracy of this analysis. Dr Mercola, however, fails to recognize that a reduction of the cost estimate does not alter the main point of our letter: that premarital screening for HIV infection does not represent rational or effective public health policy. The goal of any screening program should be the prevention of additional illness. There is no evidence that this goal has been accomplished in Illinois. The prevalence of HIV infection is extremely low among marriage license applicants and the number of cases prevented is likely to be much lower than the number of cases identified. During 1988, twenty-six (0.017%) of 155 458 Illinois marriage license applicants were seropositive, but it is not