| Abstract: | The AIDS epidemic is one of the most serious public health problems of the twentieth century. According to recent estimates, 500,000 Americans will have died or progressed into the later stages of the disease by 1992. A national, mandatory premarital testing program for AIDS, the focus of this study, is one of the actions the government could take to fight the continuing spread of AIDS. Top officials in the Reagan administration repeatedly called for the implementation of mandatory testing programs. Furthermore, Reagan himself urged states to adopt premarital testing for AIDS. Although a premarital testing program could help fight the spread of AIDS through the prevention of new AIDS cases, its economic costs and benefits remain largely unknown. An examination of the costs and benefits of premarital testing is important in determining the desirability of such a program. If benefits outweigh costs, then the program would be a desirable one. However, if the reverse is true, the program would not be worthy of funding, even if it does prevent some new cases of AIDS. This study focuses on how changes in behavorial assumptions regarding premarital sex and sexual practices after the test change the cost of each case prevented by the program. The number of couples who have premarital sex will affect the number of individuals who become infected before the test; the benefits of testing will be lower when more couples engage in premarital sex. Furthermore, if one of the marriage partners does receive a positive test result, new cases will be prevented only if the infected individual practices safe sex. Obviously the effectiveness of a testing program depends directly on these assumptions and yet to date they have not been closely examined in other studies of premarital testing. Furthermore, until this study, estimates of the cost of preventing each case of AIDS through premarital testing had not been calculated, although such estimates are crucial in determining the desirability of a premarital testing program. The study first focuses on the AIDS problem: the prevalence, incidence, and costs of AIDS. Second, elements of AIDS testing are discussed. After this general background on AIDS testing, existing federal and state AIDS testing programs are outlined. Finally, an economic analysis of premarital AIDS testing, the central focus of the study, is reported. The results of this study conclude that, under the most plausible assumptions, it would cost about |
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