Table 1.
10% prevalence | 1% prevalence | Malawi 2017a | |||||||
---|---|---|---|---|---|---|---|---|---|
Status Quo | With A0 | A0, 5% A1 error | Status Quo | With A0 | A0, 5% A1 error | Status Quo | With A0 | A0, 5% A1 error | |
Testing Strategy | Two‐test | Three‐test | Two‐test | ||||||
Algorithm specificity | 99.57% | 99.91% | 99.96% | ||||||
Verification testing cost | $5 | $7 | $5 | ||||||
False positive misclassifications per 10,000 HIV negative persons tested | |||||||||
No verificationb | 43.2 | 0.86 | 2.98 | 9.3 | 0.19 | 0.64 | 4.18 | 0.08 | 2.10 |
With verificationc | 0.64 | 0.01 | 0.04 | 0.03 | 0.001 | 0.002 | 0.04 | 0.001 | 0.02 |
PPV | |||||||||
No verificationb | 95.86% | 99.91% | 99.70% | 90.69% | 99.80% | 99.30% | 98.90% | 99.98% | 99.44% |
With verificationc | 99.94% | >99.99% | >99.99% | 99.97% | >99.99% | >99.99% | 99.99% | >99.99% | 99.99% |
Cost per FP identifiedd | $123 | $5,880 | $1,708 | $75 | $3,428 | $999 | $460 | $22,743 | $909 |
FP, false‐positive; PPV, positive predictive value. aPrevalence among HIV testing clients was 4% in Malawi in 2017. HIV prevalence among all adults was approximately 10%. b“No verification” corresponds to strategy in Figure 1A under “status quo” scenario and Figure 1D for “with A0” scenarios. c“With verification” corresponds to Figure 1B under “status quo” scenario’ and Figure 1C under “with A0” scenarios.dCost per FP identified through verification testing compared to no verification testing. Cost is calculated as the expected number of verification tests conducted (sens × prev + (1 − spec) × (1 − prev)) times the cost per verification test divided by the number of FP cases identified through verification testing.