{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T03:17:18Z","timestamp":1776914238967,"version":"3.51.2"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,25]],"date-time":"2024-02-25T00:00:00Z","timestamp":1708819200000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA045547"],"award-info":[{"award-number":["R01DA045547"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The LINC\u2010II randomized controlled trial in St. Petersburg, Russia for HIV\u2010positive adults who inject drugs found that a multi\u2010component intervention including initiation of antiretroviral therapy (ART) during admission to an addiction hospital, strengths\u2010based case management and naltrexone significantly increased 12\u2010month HIV viral suppression and ART retention. We conducted a comparative cost analysis to determine if the 12\u2010month cost of the intervention is affordable within the current Russian health system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used LINC\u2010II trial records and questionnaire responses to calculate the resources utilized by each participant in the study, including inpatient days, medications, laboratory tests, outpatient consultations, case manager interactions and opioid medication treatment. Quantities of resources utilized were multiplied by unit costs for each resource estimated from the service fee or price lists used by the study facilities for each specific service delivered. We report the average cost\/study primary (viral suppression at 12 months) or secondary (retention in care at 12 months) outcome\/participant in 2021 USD and compare costs between study arms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The trial enrolled 225 participants (111 intervention, 114 control) between September 2018 and December 2020. Viral suppression, non\u2010suppression and missing suppression results were 28% and 14%, 49% and 37%, and 31% and 41% for the control and intervention arms, respectively. Retention results were 35% and 51% for the control and intervention arms, respectively. The average cost per study participant was $2714 in the control arm and $4342 in the intervention arm. The average cost per participant virally suppressed at 12 months was $3662 (control) and $6355 (intervention). The average cost per participant retained at 12 months was $4050 (control) and $5448 (intervention). For those retained, the cost\u00a0difference between the arms was comprised of opioid treatment (35%), case management (31%), outpatient visits (18%) and additional days of ART (12%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The LINC\u2010II intervention increased the cost of care for HIV\u2010positive people who inject drugs in Russia significantly, but some components of the intervention, particularly earlier initiation of ART and case management, may be justifiable due to their success in reaching a challenging subgroup of the population in need.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Number<\/jats:title><jats:p>NCT03290391<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26208","type":"journal-article","created":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T04:34:34Z","timestamp":1708922074000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative costs and potential affordability of a multifaceted intervention to improve treatment outcomes among people with HIV who inject drugs in Russia: economic evaluation of the LINC\u2010II randomized controlled trial"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6560-2964","authenticated-orcid":false,"given":"Sydney","family":"Rosen","sequence":"first","affiliation":[{"name":"School of Public Health Boston University  Boston Massachusetts USA"},{"name":"Health Economics and Epidemiology Research Office Wits Health Consortium Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Blokhina","sequence":"additional","affiliation":[{"name":"Pavlov First State Medical University  St. Petersburg Russian Federation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8606-9209","authenticated-orcid":false,"given":"Ve","family":"Truong","sequence":"additional","affiliation":[{"name":"Clinical Addiction Research and Education (CARE) Unit Section of General Internal Medicine Department of Medicine Boston Medical Center  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agata","family":"Bereznicka","sequence":"additional","affiliation":[{"name":"Clinical Addiction Research and Education (CARE) Unit Section of General Internal Medicine Department of Medicine Boston Medical Center  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0019-762X","authenticated-orcid":false,"given":"Natalia","family":"Gnatienko","sequence":"additional","affiliation":[{"name":"Clinical Addiction Research and Education (CARE) Unit Section of General Internal Medicine Department of Medicine Boston Medical Center  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Quinn","sequence":"additional","affiliation":[{"name":"Biostatistics and Epidemiology Data Analytics Center Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dmitry","family":"Lioznov","sequence":"additional","affiliation":[{"name":"Pavlov First State Medical University  St. Petersburg Russian Federation"},{"name":"Smorodintsev Research Institute of Influenza  St. Petersburg Russian Federation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evgeny","family":"Krupitsky","sequence":"additional","affiliation":[{"name":"Pavlov First State Medical University  St. Petersburg Russian Federation"},{"name":"V.M. Bekhterev National Medical Research\u00a0Center for Psychiatry and Neurology  Saint Petersburg Russian Federation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Michals","sequence":"additional","affiliation":[{"name":"Biostatistics and Epidemiology Data Analytics Center Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8495-0350","authenticated-orcid":false,"given":"Karsten","family":"Lunze","sequence":"additional","affiliation":[{"name":"Clinical Addiction Research and Education (CARE) Unit Section of General Internal Medicine Department of Medicine Boston Medical Center  Boston Massachusetts USA"},{"name":"Section of General Internal Medicine Department of Medicine Boston University School of Medicine  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey H.","family":"Samet","sequence":"additional","affiliation":[{"name":"Clinical Addiction Research and Education (CARE) Unit Section of General Internal Medicine Department of Medicine Boston Medical Center  Boston Massachusetts USA"},{"name":"Section of General Internal Medicine Department of Medicine Boston University School of Medicine  Boston Massachusetts USA"},{"name":"Department of Community Health Sciences Boston University School of Public Health  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,2,25]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"World Health Organization ER.HIV\/AIDS surveillance in Europe 2022.2022."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/v15112156"},{"key":"e_1_2_11_4_1","unstructured":"Need Help Foundation.HIV in Russia [Internet]. [cited 2023 Jan 11]. Available from:https:\/\/tochno.st\/problems\/hiv"},{"key":"e_1_2_11_5_1","unstructured":"NikoloskiZ KingEJ MosialosE.Human immunodeficiency virus in the Russian Federation: mortality prevalence risk factors and current understanding of sexual transmission."},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-020-0179-8"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(23)00143-1"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2008.02114.x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001055"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001528"},{"key":"e_1_2_11_11_1","unstructured":"World Bank.GDP per capita (current US$)\u2014Russian Federation.2023."},{"key":"e_1_2_11_12_1","unstructured":"World Bank.The World Bank Data. Current health expenditure per capita (current $US)\u2010Russian Federation.2023."},{"key":"e_1_2_11_13_1","unstructured":"OsborneA.Findings from Optima HIV modeling analyses across 11 countries in Eastern Europe and Central Asia."},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vhri.2018.08.001"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy040"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13011-016-0087-9"},{"key":"e_1_2_11_17_1","article-title":"Cost analysis on the provision of HIV\u2010related medical services to international migrants in the Russian Federation","author":"Zayko E","year":"2021","journal-title":"Moscow: Regional Expert Group on Migration and Health"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002230"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.26208","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T05:24:49Z","timestamp":1709011489000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.26208"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/jia2.26208"],"URL":"https:\/\/doi.org\/10.1002\/jia2.26208","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2]]},"assertion":[{"value":"2023-08-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e26208"}}