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 language | English (US) |
|---|---|
| Journal | Sexually Transmitted Diseases |
| Volume | 35 |
| Issue number | 11 Suppl |
| State | Published - Nov 2008 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Dermatology
- Public Health, Environmental and Occupational Health
- Microbiology (medical)
- Infectious Diseases
Cite this
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 journal › Article
}
TY - JOUR
T1 - The program cost and cost-effectiveness of screening men for Chlamydia to prevent pelvic inflammatory disease in women.
AU - Gift, Thomas L.
AU - Gaydos, Charlotte A
AU - Kent, Charlotte K.
AU - Marrazzo, Jeanne M.
AU - Rietmeijer, Cornelis A.
AU - Schillinger, Julia A.
AU - Dunne, Eileen F.
PY - 2008/11
Y1 - 2008/11
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=58149159913&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=58149159913&partnerID=8YFLogxK
M3 - Article
C2 - 18830137
AN - SCOPUS:58149159913
VL - 35
JO - Sexually Transmitted Diseases
JF - Sexually Transmitted Diseases
SN - 0148-5717
IS - 11 Suppl
ER -