Original Paper

AIDS and Behavior

, Volume 17, Supplement 2, pp 220-226

First online:

Cost Analysis of Enhancing Linkages to HIV Care Following Jail: A Cost-Effective Intervention

  • Anne C. SpauldingAffiliated withRollins School of Public Health, Emory University Email author 
  • , Steven D. PinkertonAffiliated withDepartment of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin
  • , Hillary SuperakAffiliated withRollins School of Public Health, Emory University
  • , Marc J. CunninghamAffiliated withRollins School of Public Health, Emory University
  • , Stephen ReschAffiliated withHarvard School of Public Health Center for Health Decision Science
  • , Alison O. JordanAffiliated withNew York City Department of Health and Mental Hygiene, Transitional Health Care Coordination
  • , Zhou YangAffiliated withRollins School of Public Health, Emory University

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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.