AIDS and Behavior

, Volume 17, Supplement 2, pp 220–226 | Cite as

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

  • Anne C. Spaulding
  • Steven D. Pinkerton
  • Hillary Superak
  • Marc J. Cunningham
  • Stephen Resch
  • Alison O. Jordan
  • Zhou Yang
Original Paper


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.


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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Anne C. Spaulding
    • 1
  • Steven D. Pinkerton
    • 2
  • Hillary Superak
    • 1
  • Marc J. Cunningham
    • 1
  • Stephen Resch
    • 3
  • Alison O. Jordan
    • 4
  • Zhou Yang
    • 1
  1. 1.Rollins School of Public HealthEmory UniversityAtlantaUSA
  2. 2.Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention ResearchMedical College of WisconsinMilwaukeeUSA
  3. 3.Harvard School of Public Health Center for Health Decision ScienceBostonUSA
  4. 4.New York City Department of Health and Mental HygieneTransitional Health Care CoordinationNew YorkUSA

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