Cost Analysis of Enhancing Linkages to HIV Care Following Jail: A Cost-Effective Intervention
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We are not aware of published cost-effectiveness studies addressing community transitional programs for HIV-infected jail detainees. To address this gap, data from 9 sites of EnhanceLink, a project that enrolled HIV-infected releasees from jails across the US, were examined. Figures on the number of clients served, cost of linkage services, number of linkages and 6-month sustained linkages to community HIV care, and number of clients achieving viral suppression were assessed for subjects released in the first quarter of 2010 (n = 543). The cost analysis included all costs that participating service agencies incurred. A cost-effectiveness analysis was conducted to estimate the new HIV cases averted by EnhanceLink and the cost per quality-adjusted life year saved by the program. The mean cost per linked client was $4,219; the mean cost per 6-month sustained linkage was $4,670; and the mean cost per client achieving viral suppression was $8,432. Compared to standard care, the cost per additional quality-adjusted life year saved was $72,285, suggesting that the EnhanceLink interventions were cost-effective from the societal perspective.
- Spaulding AC, Seals RM, Page MJ, Brzozowski AK, Rhodes W, Hammett TM. HIV/AIDS among inmates of, and releasees from, US correctional facilities, 2006 declining share of epidemic but persistent public health opportunity. PLoS One. 2009;4(11):e7558. doi:10.1371/journal.pone.0007558. CrossRef
- Westergaard RP, Kirk GD, Richesson DR, Galai N, Mehta SH. Incarceration predicts virologic failure for HIV-infected injection drug users receiving antiretroviral therapy. Clin Infect Dis. 2011;53(7):725–31. CrossRef
- National HIV/AIDS strategy for the United States. 2010. http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf. Accessed 3 Dec 2010.
- Shrestha RK, Sansom SL, Richardson-Moore A, et al. Costs of voluntary rapid HIV testing and counseling in jails in 4 states advancing HIV prevention demonstration project 2003–2006. Sex Transm Dis. 2009;36(Suppl 2):S5–8.
- Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr: JAIDS. 2005;39(4):446–53. CrossRef
- Holtgrave DR, Hall HI, Rhodes PH, Wolitski RJ. Updated annual HIV transmission rates in the United States, 1977–2006 (Letter to the editor). J Acquir Immune Defic Syndr. 2009;50:236–8. CrossRef
- Draine J, Ahuja D, Altice FL, et al. Strategies to enhance linkages between care for HIV/AIDS in jail and community settings. AIDS Care. 2011;23(3):366–77. CrossRef
- Pinkerton S. HIV Transmission rate modeling: a primer, review, and extension. AIDS Behav. 2012;16(4):791–6. CrossRef
- Centers for Disease Control and Prevention. HIV surveillance—United States, 1981–2008. MMWR. 2011;60:689–93.
- Prejean J, Song R, Hernandez A, et al. Estimated HIV incidence in the United States, 2006–2009. PLoS One. 2011;6(8):e17502. CrossRef
- Gardner LI, Metsch LR, Anderson-Mahoney P, et al. Efficacy of a brief case management intervention to link recently diagnosed HIV-infected persons to care. AIDS. 2005;19(4):423–31. CrossRef
- Hutchinson AB, Farnham PG, Dean HD, Ekwueme DU, del Rio C, Kamimoto L. The economic burden of HIV in the US in the era of highly active antiretroviral therapy: evidence of continuing racial and ethnic differences. JAIDS. 2006;43(4):451–7. CrossRef
- Gebo KA, Fleishman JA, Conviser R, et al. Contemporary costs of HIV healthcare in the HAART era. AIDS. 2010;24(17):2705–15. CrossRef
- Schackman BR, Gebo KA, Walensky RP, et al. The lifetime cost of current human immunodeficiency virus care in the United States. Med Care. 2006;44(11):990–7. CrossRef
- Farnham PG, Sansom SL, Hutchinson AB. How much should we pay for a new HIV diagnosis? A mathematical model of HIV screening in US clinical settings. Méd Decis Mak. 2012;32(3):459–69. CrossRef
- Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505. CrossRef
- Quinn TC, Wawer MJ, Sewankambo N, et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. N Engl J Med. 2000;342(13):921–9. CrossRef
- Centers for disease control and prevention. HIV cost-effectiveness. 2012. http://www.cdc.gov/hiv/topics/preventionporgrams/ce/index.htm. Accessed 15 Jun 2012.
- CDC'S new high-impact approach to HIV prevention funding for health departments advancing the national HIV/AIDS strategy. Fact sheet. 2011. http://www.cdc.gov/hiv/topics/funding/PS12-1201/resources/factsheet/pdf/foa-partner.pdf. Accessed 5 Sept 2011.
- NIH, office of AIDS research. Translating research from bench to bedside to community. 2010. http://www.oar.nih.gov/strategicplan/fy2011/pdf/FY2011ByPassPlan_08_Plan.pdf in FY Trans-NIH Plan for HIV-related research, available at: http://www.oar.nih.gov/strategicplan/fy2011/index.asp. Accessed 6 Mar 2010.
- Cohen SM, van Handel MM, Branson BM, et al. Vital Signs: HIV prevention through care and treatment—United States MMWR. 2011;60(47):1618–23.
- Pinkerton SD. How many sexually-acquired HIV infections in the USA are due to acute phase HIV transmission? AIDS. 2007;21:1625–29.
- Marks G, Crepaz N, Janssen RS. Estimating sexual transmission of HIV from persons aware and unaware that they infected with the virus in the USA. AIDS. Jun 26 2006;20(10):1447–50.
- Cost Analysis of Enhancing Linkages to HIV Care Following Jail: A Cost-Effective Intervention
AIDS and Behavior
Volume 17, Issue 2 Supplement, pp 220-226
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- Springer US
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- Author Affiliations
- 1. Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
- 2. Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 2071 N Summit Ave, Milwaukee, WI, USA
- 3. Harvard School of Public Health Center for Health Decision Science, 718 Huntington Ave, Boston, MA, USA
- 4. New York City Department of Health and Mental Hygiene, Transitional Health Care Coordination, New York, NY, USA