AEGiS-14IAC: The cost of antiretroviral treatment in a county detention center.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

The cost of antiretroviral treatment in a county detention center.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. E11437)

Mayne DJ, Macher A, Kent C, Kassa L, Barry S
Fairfax County Adult Detention Center, Fairfax, United States

BACKGROUND: When HIV-infected persons are incarcerated, the correctional facilities are obligated to provide the standard of care; the associated health care costs must be absorbed by the correctional facilities, including all treatment costs for pre-sentenced detainees. Provision of effective treatment to inmates with HIV/AIDS is a significant financial burden to the jails.

METHODS: In a unique collaborative clinical project between our county detention center and the U.S. Public Health Service, we developed and implemented a prototypical on-site multidisciplinary chronic care HIV clinic staffed by nurses, an internist and a clinical pathologist. All of the inmates housed in our correctional facility have access to state-of-the-art HIV care and treatment as delineated in the U.S. Department of Health and Human Services' Antiretroviral Treatment Guidelines (www.hivatis.org). Continuous quality control monitoring of our program includes monthly assessments of our treatment costs.

RESULTS: From January 2000 through December 2001, our average monthly inmate population receiving antiretroviral treatment was 18. From January 2000 through December 2000, total pharmaceutical expenditures amounted to $456,527; the two leading costs included HIV-related medications (44%) and psychotropics (47%). From January 2001 through December 2001 total pharmaceutical costs were $540,456; HIV represented 35% and psychotropics 56%. Approximately 50% of our annual $41,000 laboratory testing budget was spent on inmates with HIV/AIDS.

CONCLUSION: The cost of comprehensive state-of-the-art antiretroviral treatment for inmates with HIV/AIDS at our correctional facility represents a major component of our total health services budget.

Keywords: AEGIS, HIV, HIV Infections, Acquired Immunodeficiency Syndrome, Prisoners, Prisons, Antiretroviral Therapy, Highly Active, HIV Seroprevalence, Anti-HIV Agents, Delivery of Health Care, Health Expenditures, United States, Human, therapy, economics, drug therapy

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