Return on Investment: Impact of STD Prevention Efforts

Three CDC studies show how federally-funded efforts to prevent sexually transmitted diseases (STDs) have dramatically reduced STDs and their associated health costs.

The first study^¹ provided evidence that funding for STD and HIV prevention has a discernable impact on new cases of STDs. The authors found that greater amounts of federal STD and HIV prevention funding in a given year are associated with reductions in reported gonorrhea rates at the state level in following years. Results suggest that each dollar of prevention funding (per capita) is associated with a later decrease in gonorrhea of up to 20 percent. Because gonorrhea is a marker for risky sexual behavior, the findings are likely generalizable to other STDs, including HIV.

The second study^² examined the impact of federally-funded STD prevention efforts over the past 33 years, estimating that approximately 32 million cases of gonorrhea were avoided from 1971 to 2003 as a result of prevention efforts. The study demonstrated that STD prevention programs paid for themselves. Savings realized by preventing gonorrhea exceeded the STD prevention program expenditures by more than $3.7 billion during the 33-year period. If other benefits were considered (such as the prevention of other STDs), the estimated effectiveness and cost-effectiveness of STD prevention in the United States would be even greater.

In the third study^³, researchers estimated that reductions in new cases of gonorrhea and syphilis from 1990 to 2003 saved $5.0 billion in direct medical costs. This estimate was based on reported cases of the two diseases in the United States, coupled with published estimates of direct medical costs per STD case. Authors calculated that the total direct medical cost of gonorrhea and syphilis was $3.8 billion over the 14-year period, compared to $8.9 billion if STD rates had remained at their 1990 levels. Because gonorrhea and syphilis infection are known to increase the risk of HIV transmission, a significant portion ($3.9 billion) of the total savings ($5.0 billion) reflected HIV infections that were averted due to reduced gonorrhea and syphilis rates.

¹Chesson HW, Harrison P, Scotton CR, and Varghese B. Does funding for HIV and sexually transmitted disease prevention matter? Evidence from panel data. Evaluation Review 2005; 29(1): 3-23.

²Chesson HW. Estimated effectiveness and cost-effectiveness of federally-funded prevention efforts on gonorrhea rates in the United States, 1971-2003, under various assumptions about the impact of prevention funding. Sexually Transmitted Diseases 2006; 33(10): S140-S144.

³Chesson HW, Gift TL, Pulver ALS. The economic value of reductions in gonorrhea and syphilis incidence in the United States, 1990-2003. Preventive Medicine 2006; 43: 411–415.

More Information on STDs and STD Prevention

• Chlamydia
• Gonorrhea
• Syphilis
• HIV/AIDS and STDs
• Infertility and STDs
• 2005 STD Surveillance Report
• Program Operations Guidelines for STD Prevention