title: Cost-Utility Analysis of Three U.S. HIV Linkage and Re-engagement in Care Programs from Positive Charge.
abstract: Linking and retaining people living with HIV in ongoing, HIV medical care is vital for ending the U.S. HIV epidemic. Yet, 41-44 % of HIV+ individuals are out of care. In response, AIDS United initiated Positive Charge, a series of five HIV linkage and re-engagement projects around the U.S. This paper investigates whether three Positive Charge programs were cost effective and calculates a return on investment for each program. It uses standard methods of cost utility analysis and WHO-CHOICE thresholds. All three projects were found to be cost effective, and two were highly cost effective. Cost utility ratios ranged from $4439 to $137,271. These results suggest that HIV linkage to care programs are a productive and efficient use of public health funds.
authors.affiliation: Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA. kjain3@jhu.edu.
authors.forename: Kriti M
authors.initials: KM
authors.lastname: Jain
authors.affiliation: Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA.
authors.forename: Rose
authors.initials: R
authors.lastname: Zulliger
authors.affiliation: Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA.
authors.forename: Cathy
authors.initials: C
authors.lastname: Maulsby
authors.affiliation: Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA.
authors.forename: Jeeyon Janet
authors.initials: JJ
authors.lastname: Kim
authors.affiliation: AIDS United, Washington, DC, USA.
authors.forename: Vignetta
authors.initials: V
authors.lastname: Charles
authors.affiliation: AIDS United, Washington, DC, USA.
authors.forename: Maura
authors.initials: M
authors.lastname: Riordan
authors.affiliation: Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA.
authors.forename: David
authors.initials: D
authors.lastname: Holtgrave
mesh_terms: D019380:Anti-HIV Agents / Q000191:economics* / Q000627:therapeutic use; D002641:Chicago; D003153:Community Health Services / Q000191:economics*; D003266:Continuity of Patient Care / Q000191:economics*; D003362:Cost-Benefit Analysis; D015658:HIV Infections / Q000191:economics / Q000628:therapy*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D008145:Louisiana; D009313:National Health Programs; D009519:New York City; D010342:Patient Acceptance of Health Care; D019057:Quality-Adjusted Life Years; D014481:United States
chemical_list: D019380:Anti-HIV Agents
keywords: Cost effective; Cost saving; Cost utility analysis; HIV; Linkage to care; Retention in care