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June 16, 1989, Vol 261, No. 23 >
ARTICLE | June 16, 1989

Premarital AIDS Testing: Public Policy Abandoned at the Altar

Stephen C. Joseph, MD, MPH
JAMA. 1989;261(23):3456. doi:10.1001/jama.1989.03420230110037.
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In detailing the impact over 6 months of the legislatively mandated premarital human immunodeficiency virus (HIV) screening program in Illinois, Turnock and Kelly's1 article in this issue of The Journal is an important effort by a public health agency to subject a legislative initiative to a comprehensive impact analysis. The article establishes that eight seropositive individuals were identified out of 70 846 applicants for marriage licenses, at an estimated cost of $2.5 million. After analyzing the economic, social, and public health implications of the program, the article concludes that Illinois' experience with premarital HIV screening shows mandatory or publicly supported HIV antibody screening of low-prevalence populations is not cost-effective and has no positive impact on disease prevention.

This adds firm evidence to the impressions in other localities attempting or considering such programs. In New York City, premarital HIV screening was one of a range of public policy issues that

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