The program cost and cost-effectiveness of screening men for Chlamydia to prevent pelvic inflammatory disease in women.

Thomas L. Gift, Charlotte A Gaydos, Charlotte K. Kent, Jeanne M. Marrazzo, Cornelis A. Rietmeijer, Julia A. Schillinger, Eileen F. Dunne

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Because men transmit Chlamydia trachomatis to women, screening men to prevent pelvic inflammatory disease in women may be a viable strategy. However, the cost-effectiveness of this approach requires careful assessment. METHODS: Data from a demonstration project and longitudinal study that examined screening men for chlamydia were applied to a compartment-based transmission model to estimate the cost-effectiveness of screening men for chlamydia compared with alternative interventions, including expanded screening of women and combining disease investigation specialist-provided partner notification with screening. Cases of pelvic inflammatory disease and quality-adjusted life years lost were the primary outcome measures. A male screening program that screened 1% of men in the population annually was modeled. RESULTS: A program targeting high-risk men for screening (those with a larger number of partners in the previous year than the general population and a higher chlamydia prevalence) was cost saving compared with using equivalent program dollars to expand screening of lower-risk women. Combining partner notification with male screening was more effective than screening men alone. In sensitivity analyses, the male program was not always cost saving but averaged $10,520 per quality-adjusted life year saved over expanded screening of women. CONCLUSIONS: Screening men can be a cost-effective alternative to screening women, but the men screened must have a relatively high prevalence compared with the women to whom screening would be expanded (under baseline assumptions, the prevalence in screened men was 86% higher than that of screened women). These modeling results suggest that programs targeting venues that have access to high-risk men can be effective tools in chlamydia prevention.

Original languageEnglish (US)
JournalSexually Transmitted Diseases
Volume35
Issue number11 Suppl
StatePublished - Nov 2008
Externally publishedYes

Fingerprint

Pelvic Inflammatory Disease
Chlamydia
Cost-Benefit Analysis
Costs and Cost Analysis
Contact Tracing
Quality-Adjusted Life Years
Chlamydia trachomatis
Population
Longitudinal Studies
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Gift, T. L., Gaydos, C. A., Kent, C. K., Marrazzo, J. M., Rietmeijer, C. A., Schillinger, J. A., & Dunne, E. F. (2008). The program cost and cost-effectiveness of screening men for Chlamydia to prevent pelvic inflammatory disease in women. Sexually Transmitted Diseases, 35(11 Suppl).

The program cost and cost-effectiveness of screening men for Chlamydia to prevent pelvic inflammatory disease in women. / Gift, Thomas L.; Gaydos, Charlotte A; Kent, Charlotte K.; Marrazzo, Jeanne M.; Rietmeijer, Cornelis A.; Schillinger, Julia A.; Dunne, Eileen F.

In: Sexually Transmitted Diseases, Vol. 35, No. 11 Suppl, 11.2008.

Research output: Contribution to journalArticle

Gift, TL, Gaydos, CA, Kent, CK, Marrazzo, JM, Rietmeijer, CA, Schillinger, JA & Dunne, EF 2008, 'The program cost and cost-effectiveness of screening men for Chlamydia to prevent pelvic inflammatory disease in women.', Sexually Transmitted Diseases, vol. 35, no. 11 Suppl.
Gift, Thomas L. ; Gaydos, Charlotte A ; Kent, Charlotte K. ; Marrazzo, Jeanne M. ; Rietmeijer, Cornelis A. ; Schillinger, Julia A. ; Dunne, Eileen F. / The program cost and cost-effectiveness of screening men for Chlamydia to prevent pelvic inflammatory disease in women. In: Sexually Transmitted Diseases. 2008 ; Vol. 35, No. 11 Suppl.
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abstract = "BACKGROUND: Because men transmit Chlamydia trachomatis to women, screening men to prevent pelvic inflammatory disease in women may be a viable strategy. However, the cost-effectiveness of this approach requires careful assessment. METHODS: Data from a demonstration project and longitudinal study that examined screening men for chlamydia were applied to a compartment-based transmission model to estimate the cost-effectiveness of screening men for chlamydia compared with alternative interventions, including expanded screening of women and combining disease investigation specialist-provided partner notification with screening. Cases of pelvic inflammatory disease and quality-adjusted life years lost were the primary outcome measures. A male screening program that screened 1{\%} of men in the population annually was modeled. RESULTS: A program targeting high-risk men for screening (those with a larger number of partners in the previous year than the general population and a higher chlamydia prevalence) was cost saving compared with using equivalent program dollars to expand screening of lower-risk women. Combining partner notification with male screening was more effective than screening men alone. In sensitivity analyses, the male program was not always cost saving but averaged $10,520 per quality-adjusted life year saved over expanded screening of women. CONCLUSIONS: Screening men can be a cost-effective alternative to screening women, but the men screened must have a relatively high prevalence compared with the women to whom screening would be expanded (under baseline assumptions, the prevalence in screened men was 86{\%} higher than that of screened women). These modeling results suggest that programs targeting venues that have access to high-risk men can be effective tools in chlamydia prevention.",
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