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STDs and the increased risk for HIV transmission: implications
for cost-effectiveness analyses of STD prevention interventions.
Journal of Acquired Immune Deficiency Syndromes 2000;24(1):48-56.
Chesson HW, Pinkerton SD.
Abstract
We estimated the annual number and cost of new HIV infections in the United
States attributable to other sexually transmitted diseases (STDs). We used
a mathematical model of HIV transmission to estimate the probability that
a given STD infection would facilitate HIV transmission from an HIV-infected
person to his or her partner and to calculate the number of HIV infections
due to these facilitative effects. In 1996, an estimated 5,052 new HIV cases
were attributable to the four STDs considered here: chlamydia (3,249 cases),
syphilis (1,002 cases), gonorrhea (430 cases), and genital herpes (371 cases).
These new HIV cases account for approximately $985 million U.S. in direct
HIV treatment costs. The model suggested that syphilis is far more likely
than the other STDs (on a per-case basis) to facilitate HIV transmission.
This analysis provides a framework for incorporating STD-attributable HIV
treatment costs into cost-effectiveness analyses of STD prevention programs.