{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T13:12:39Z","timestamp":1769605959181,"version":"3.49.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T00:00:00Z","timestamp":1638835200000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000030","name":"centers for disease control and prevention","doi-asserted-by":"publisher","award":["5NU65PS923685-02-00"],"award-info":[{"award-number":["5NU65PS923685-02-00"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Harm Reduct J"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>While there is a general acceptance among public health officials and policy-makers that syringe services programs can be effective in reducing HIV transmission among persons who inject drugs, local syringe services programs are often asked to provide economic justifications for their activities. A cost-effectiveness study, estimating the cost of preventing one HIV infection, would be the preferred methods for addressing this economic question, but few local syringe services programs have the needed data, staff and epidemiologic modeling resources needed for a cost\u2013effectiveness study. We present a method for estimating a threshold value for the number of HIV infections prevented above which the program will be cost-saving to society. An intervention is considered \u201ccost-saving\u201d when it leads to a desirable health outcome a lower cost than the alternative.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The research literature on the effectiveness of syringe services programs in controlling HIV transmission among persons who inject drugs and guidelines for syringe services program that are \u201cfunctioning very well\u201d were used to estimate the cost-saving threshold at which a syringe services program becomes cost-saving through preventing HIV infections versus lifetime treatment of HIV. Three steps are involved: (1) determining if HIV transmission in the local persons who inject drugs (PWID) population is being controlled, (2) determining if the local syringe services program is functioning very well, and then (3) dividing the annual budget of the syringe services program by the lifetime cost of treating a single HIV infection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A syringe services program in an area with controlled HIV transmission (with HIV incidence of 1\/100 person-years or less), functioning very well (with high syringe coverage, linkages to other services, and monitoring the local drug use situation), and an annual budget of $500,000 would need to prevent only 3 new HIV infections per year to be cost-saving.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Given the high costs of treating HIV infections, syringe services programs that are operating according to very good practices (\u201cfunctioning very well\u201d) and in communities in which HIV transmission is being controlled among persons who inject drugs, will almost certainly be cost-saving to society.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12954-021-00575-4","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T09:02:52Z","timestamp":1638867772000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Is your syringe services program cost-saving to society? A methodological case study"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0157-8168","authenticated-orcid":false,"given":"Don C.","family":"Des Jarlais","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Feelemyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney","family":"McKnight","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Knudtson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara N.","family":"Glick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,12,7]]},"reference":[{"key":"575_CR1","unstructured":"Centers for Disease Control & Prevention. Summary of information on the safety and effectiveness of syringe services programs (SSPs). Atlanta; 2019."},{"issue":"10","key":"575_CR2","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1046\/j.1525-1497.1998.00211.x","volume":"13","author":"DK Owens","year":"1998","unstructured":"Owens DK. Interpretation of cost-effectiveness analyses. J Gen Intern Med. 1998;13(10):716.","journal-title":"J Gen Intern Med"},{"issue":"8","key":"575_CR3","doi-asserted-by":"publisher","first-page":"695","DOI":"10.3109\/10826089309062167","volume":"28","author":"Y-I Hser","year":"1993","unstructured":"Hser Y-I. Population estimates of intravenous drug users and HIV infection in Los Angeles County. 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