Methods for Sexually Transmitted Disease Prevention Programs to Estimate the Health and Medical Cost Impact of Changes in Their Budget

Chesson, Harrell W.; Ludovic, Jennifer A.; Berruti, Andrés A.; Gift, Thomas L.

doi:10.1097/olq.0000000000000747

Cited by 10 publications

(12 citation statements)

References 30 publications

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“…[47][48][49][50] These previous estimates have also been incorporated in spreadsheet-based tools that allow STI program personnel to estimate the health and economic impact of their program activities. 37,51 Our study, along with the other studies in this Special Issue, can inform updates of these existing tools. Further, we hope that this Special Issue can help to spur the development of new tools that would allow for state and local STI program personnel to estimate the cost burden of STIs in their jurisdictions and the cost-effectiveness of their activities.…”

Section: Lifetime Medical Costs Of Stismentioning

confidence: 87%

“…7,35 Although estimating the annual cost of STI prevention activities was beyond the scope of this study, evidence suggests that reductions in current investments for STI prevention would result in subsequent increases in lifetime medical costs that could exceed the reductions in investments in prevention. [36][37][38] Thus, all else equal, we would expect that the cost of incident STIs in future years would be notably higher in the absence of STI prevention efforts than would be expected if current prevention efforts were continued or enhanced. Similarly, all else equal, we would expect the cost of incident STIs in future years to increase under scenarios of population-level changes in sexual behavior, such as decreases in condom usage or increases in the number of sex partners.…”

Section: Discussionmentioning

confidence: 99%

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The Estimated Direct Lifetime Medical Costs of Sexually Transmitted Infections Acquired in the United States in 2018

Chesson¹,

Spicknall²,

Bingham

et al. 2021

Sexual Trans Dis

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Background:We estimated the lifetime medical costs attributable to sexually transmitted infections (STIs) acquired in 2018, including sexually acquired human immunodeficiency virus (HIV). Methods:We estimated the lifetime medical costs of infections acquired in 2018 in the United States for 8 STIs: chlamydia, gonorrhea, trichomoniasis, syphilis, genital herpes, human papillomavirus (HPV), hepatitis B, and HIV. We limited our analysis to lifetime medical costs incurred for treatment of STIs and for treatment of related sequelae; we did not include other costs, such as STI prevention. For each STI, except HPV, we calculated the lifetime medical cost by multiplying the estimated number of incident infections in 2018 by the estimated lifetime cost per infection. For HPV, we calculated the lifetime cost based on the projected lifetime incidence of health outcomes attributed to HPV infections acquired in 2018. Future costs were discounted at 3% annually.Results: Incident STIs in 2018 imposed an estimated $15.9 billion (25 th -75 th percentile: $14.9-16.9 billion) in discounted, lifetime direct medical costs (2019 US dollars). Most of this cost was due to sexually acquired HIV ($13.7 billion) and HPV ($0.8 billion). STIs in women accounted for about one fourth of the cost of incident STIs when including HIV, but about three fourths when excluding HIV. STIs among 15-to 24-year-olds accounted for $4.2 billion (26%) of the cost of incident STIs.Conclusions: Incident STIs continue to impose a considerable lifetime medical cost burden in the United States. These results can inform health economic analyses to promote the use of cost-effective STI prevention interventions to reduce this burden.

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Section: Lifetime Medical Costs Of Stismentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

The Estimated Direct Lifetime Medical Costs of Sexually Transmitted Infections Acquired in the United States in 2018

Chesson¹,

Spicknall²,

Bingham

et al. 2021

Sexual Trans Dis

Self Cite

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“…Second, we incorporated downward adjustments to account for factors such as HIV serosorting and partner overlap (e.g., person C cannot acquire an STI-attributable HIV infection from both person A and person B), [17][18][19][20] as was done in previous studies. 14,16 Third, we further decreased the downward-adjusted values by an additional 56% to account for reductions in HIV transmission due to viral suppression among those with HIV and preexposure prophylaxis (PrEP) among those without HIV. This 56% reduction represents the combined effect of an assumed 50% reduction due to viral suppression (based on reports that approximately 50% of people with HIV in the United States are virally suppressed) 22 and an assumed 12% reduction due to PrEP (based on estimated PrEP coverage of 12% among those indicated for PrEP in the United States).…”

Section: Calculation Methods 2: Using Model-based Estimates Of the Nu...mentioning

confidence: 99%

“…Given the availability of model-based estimates of the percentage of HIV infections attributable to STIs, 3 estimates of STI incidence in 2018, 12 updated estimates of the average lifetime medical cost per HIV infection, 13 and other relevant data, 8,9,14 the purpose of this study was to estimate the number and lifetime medical cost of HIV infections attributable to 4 incident STIs (gonorrhea, chlamydia, syphilis, and trichomoniasis) in the United States in 2018. We did not include viral STIs such as genital herpes.…”

mentioning

confidence: 99%

The Estimated Number and Lifetime Medical Cost of HIV Infections Attributable to Sexually Transmitted Infections Acquired in the United States in 2018: A Compilation of Published Modeling Results

Chesson¹,

Song

Bingham

et al. 2021

Sexual Trans Dis

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Background:The purpose of this study was to estimate the number and lifetime medical cost of HIV infections attributable to incident sexually transmitted infections (STIs) in the United States in 2018. Methods:We combined data from published models regarding the number or percentage of HIV infections attributable to STIs with updated estimates of the lifetime medical cost per HIV infection. We used 2 distinct calculation methods. Our first calculation used recent estimates of the percentage of HIV infections in men who have sex with men (MSM) attributable to gonorrhea and chlamydia. Our second calculation, based on older studies, used estimates of the expected number of STI-attributable HIV infections per new STI infection, for gonorrhea, chlamydia, syphilis, and trichomoniasis.Results: Our first calculation method suggested that 2489 (25th-75th percentiles, 1895-3000) HIV infections in 2018 among MSM could be attributed to gonorrhea and chlamydia, at an estimated lifetime medical cost of $1.05 billion (25th-75th percentiles, $0.79-$1.26 billion). Our second calculation method suggested that 2349 (25th-75th percentiles, 1948-2744) HIV infections in the general population (including MSM) could be attributed to chlamydia, gonorrhea, syphilis, and trichomoniasis acquired in 2018, at an estimated lifetime medical cost of $0.99 billion (25th-75th percentiles, $0.80-$1.16 billion).Conclusions: Despite ambiguity regarding the degree to which STIs affect HIV transmission, our combination of data from published STI/HIV transmission models and an HIV lifetime medical cost model can help to quantify the estimated burden of STI-attributable HIV infections in the United States.

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“…confrontations. Despite this obstacle, STDs can be potentially controlled by several well-established activities, such as partner notification, which involves interviewing individuals diagnosed with STDs, obtaining information about their sexual partners, and locating these partners so that they can be referred for testing and treatment (10,11).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Sexually Transmitted Diseases in Men of 25 - 60 Years in Iran

et al. 2021

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Background: Sexually transmitted diseases (STDs), especially in men, can lead to multiple morbidities and facilitate the transmission of serious pathogens, such as the human immunodeficiency virus. The present study used the data from a nationwide survey on male morbidities to estimate the prevalence of STDs among men in Iran. Methods: This cross-sectional study used the data from a nationwide project on male reproductive morbidities in 2007. A total of 2296 men within the age range of 25 - 60 years were recruited by systematic cluster sampling from four provinces (i.e., Golestan, Hormozgan, Kermanshah, and Isfahan, Iran). The data on the symptoms of STDs, including genital secretion, pushing out, itching or genital ulcers, and lymphadenopathy of the inguinal area after sexual contact, were collected by trained urologists. Data analysis was carried out using SPSS software (version18.0, Chicago, IL, USA). The independent samples t-test and chi-square test were used for data analysis. Results: A total of 2296 men with a mean age value of 39.95 ± 10.3 years were interviewed in this study. Two-thirds of all the subjects (75%) were aware of using condoms in suspected sexual relationships; however, only 69% of the aforementioned subjects used condoms in those circumstances. Overall, 14 subjects (0.6%) had one type of STDs at the study time. Moreover, 110 subjects (4.7%) answered “yes” to the question of whether they were referred to a physician for sexual problems. Conclusions: The prevalence of STDs is still low among the male population in Iran. Careful and well-designed surveillance systems to monitor the incidence of STDs and proper preventive measures to restrict the spread of sexually transmitted pathogens are among the proposed recommendations.

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Methods for Sexually Transmitted Disease Prevention Programs to Estimate the Health and Medical Cost Impact of Changes in Their Budget

Abstract: The methods we proposed, though subject to important limitations, can allow STD prevention personnel to calculate evidence-based estimates of the effects of changes in their budget.

Cited by 10 publications

References 30 publications

The Estimated Direct Lifetime Medical Costs of Sexually Transmitted Infections Acquired in the United States in 2018

The Estimated Direct Lifetime Medical Costs of Sexually Transmitted Infections Acquired in the United States in 2018

The Estimated Number and Lifetime Medical Cost of HIV Infections Attributable to Sexually Transmitted Infections Acquired in the United States in 2018: A Compilation of Published Modeling Results

Prevalence of Sexually Transmitted Diseases in Men of 25 - 60 Years in Iran

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