AIDS and Behavior

, Volume 17, Issue 8, pp 2676–2684 | Cite as

Cost and Threshold Analysis of an HIV/STI/Hepatitis Prevention Intervention for Young Men Leaving Prison: Project START

  • A. P. JohnsonEmail author
  • R. J. MacGowan
  • G. D. Eldridge
  • K. M. Morrow
  • J. Sosman
  • B. Zack
  • A. Margolis
  • The Project START Study Group
Original Paper


The objectives of this study were to: (a) estimate the costs of providing a single-session HIV prevention intervention and a multi-session intervention, and (b) estimate the number of HIV transmissions that would need to be prevented for the intervention to be cost-saving or cost-effective (threshold analysis). Project START was evaluated with 522 young men aged 18–29 years released from eight prisons located in California, Mississippi, Rhode Island, and Wisconsin. Cost data were collected prospectively. Costs per participant were $689 for the single-session comparison intervention, and ranged from $1,823 to 1,836 for the Project START multi-session intervention. From the incremental threshold analysis, the multi-session intervention would be cost-effective if it prevented one HIV transmission for every 753 participants compared to the single-session intervention. Costs are comparable with other HIV prevention programs. Program managers can use these data to gauge costs of initiating these HIV prevention programs in correctional facilities.


HIV AIDS Prevention Prison Cost 


Los objetivos de este estudio fueron: (a) estimar los costos de proveer una intervención de prevención del VIH en una sola sesión y una intervención en sesiones múltiples; y (b) estimar el número de transmisiones de VIH que habría que evitar para que la intervención ahorre costos o sea costo-efectiva (análisis de umbral). El proyecto START se evaluó con 522 hombres jóvenes de 18 a 29 años liberados de ocho prisiones de California, Mississippi, Rhode Island y Wisconsin. Los datos de costos se recogieron de forma prospectiva. Los costos por participante fueron de $689 para la intervención de comparación en una sola sesión, y osciló entre $1823 a $1836 para la intervención del proyecto multi-sesión START. A partir del análisis de umbral incremental, la intervención en sesiones múltiples sería costo-efectiva si se impide una transmisión del VIH por cada 753 participantes en comparación con la intervención en una sola sesión. Los costos son comparables con otros programas de prevención del VIH. Directores de programas pueden usar estos datos para determinar los costos de iniciar estos programas de prevención del VIH en centros penitenciarios.



This study was funded through cooperative agreement numbers 414879, 514804, 114812, 914806 by the Centers for Disease Control and Prevention under program announcement number 97050. The authors acknowledge funding from the Canada Research Chairs Program for Ana P. Johnson. The authors thank the study participants and the members of the Project START Study group for their contribution in conducting the study. Project START Study Group members are: John Askew, Lisa Belcher, Gina Best, Jessica Berzowski, Don Bourque, Jeff Buckles, Mark Charles, Achintya N. Dey, Melissa Dispigno, Gloria Eldridge, Christine Fitzgerald, Timothy Flanigan, Marty Fortenberry, Olga Grinstead, Juarlyn Gaiter, Kellie Green, Jacki Hecht, Kashif Iqbal, Brenda Jackson, Ana P. Johnson, Daryl Johnson, Jaclynn Kurpewski, Deborah Kacanek, Carolyn King, Katie Kramer, Melanie Krapf, Annette Lerma, Ricky Lugo, Robin MacGowan, Moribe Lumumba, Kelly Malen, Andrew Margolis, Tim McAuliffe, Kathleen Morrow, Jill Nealey-Moore, Susan Moss, Mobette Nacua, Ann O’Leary, James Sosman, Stephanie Paton, Michael Patterson, Barbara Reed, Ricardo Reed, Merjo Roca, Noel Rosado, David Seal, Rodney Simms, Kimberly Starr, Daniel Strother, Mary Turk, Jerry Vardaman, John M. Williamson, Richard Wolitski, Meghan Woods, Barry Zack.


The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • A. P. Johnson
    • 1
    Email author
  • R. J. MacGowan
    • 2
  • G. D. Eldridge
    • 3
  • K. M. Morrow
    • 4
  • J. Sosman
    • 5
  • B. Zack
    • 6
  • A. Margolis
    • 2
  • The Project START Study Group
  1. 1.Department of Community Health and EpidemiologyQueen’s UniversityKingstonCanada
  2. 2.Centers for Disease Control and PreventionAtlantaGeorgia
  3. 3.Department of PsychologyUniversity of Alaska AnchorageAnchorageUSA
  4. 4.Centers for Behavioral and Preventive MedicineThe Miriam Hospital and Warren Alpert Medical School of Brown UniversityProvidenceUSA
  5. 5.Division of General Medicine and Infectious DiseasesUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  6. 6.The Bridging GroupOaklandUSA

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