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Abstract Details
The Estimated Direct Lifetime Medical Costs of Sexually Transmitted Infections Acquired in the United States in 2018
Sex Transm Dis. 2021 Jan 23. doi: 10.1097/OLQ.0000000000001380. Online ahead of print.
Harrell W Chesson1, Ian H Spicknall, Adrienna Bingham, Marc Brisson, Samuel T Eppink, Paul G Farnham, Kristen M Kreisel, Sagar Kumar, Jean-François Laprise, Thomas A Peterman, Henry Roberts, Thomas L Gift
Author information
1Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of STD Prevention Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention Centre de recherche du CHU de Québec-Université Laval, Québec, Canada Département de médecine sociale et préventive, Université Laval, Québec, Canada Department of Infectious Disease Epidemiology, Imperial College, London, UK Oak Ridge Institute of Science and Education, Oak Ridge, Tennessee Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Viral Hepatitis.
Abstract
Background: We estimated the lifetime medical costs attributable to STIs acquired in 2018, including sexually acquired HIV.
Methods: We estimated the lifetime medical costs of infections acquired in 2018 in the United States for eight 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 (25th-75th percentile: $14.9-16.9 billion) in discounted, lifetime direct medical costs (2019 U.S. 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 15-24-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.