Kathleen L. Irwin

The Estimated Direct Medical Cost of Sexually Transmitted Diseases Among American Youth, 2000

CONTEXT Each year, millions of U.S. youth acquire sexually transmitted diseases (STDs). Estimates of the economic burden of STDs can help to quantify the impact of STDs on the nations youth and on the payers of the cost of their medical care. METHODS We synthesized the existing literature on STD costs to estimate the lifetime medical cost per case of eight major STDs-HIV, human papillomavirus (HPV), genital herpes simplex virus type 2, hepatitis B, chlamydia, gonorrhea, trichomoniasis and syphilis. We then estimated the total burden of disease by multiplying these cost-per-case estimates by the approximate number of new cases of STDs acquired by youth aged 15-24. RESULTS The total estimated burden of the nine million new cases of these STDs that occurred among 15-24-year-olds in 2000 was

Direct medical cost of pelvic inflammatory disease and its sequelae : Decreasing, but still substantial

6.5 billion (in year 2000 dollars). Viral STDs accounted for 94% of the total burden (

The acceptability of voluntary HIV antibody testing in the United States: a decade of lessons learned

6.2 billion), and nonviral STDs accounted for 6% of the total burden (

High-Risk Sex Behavior Among Young Street-Recruited Crack Cocaine Smokers in Three American Cities: An Interim Report

0.4 billion). HIV and HPV were by far the most costly STDs in terms of total estimated direct medical costs, accounting for 90% of the total burden (

The high-risk sexual practices of crack-smoking sex workers recruited from the streets of three American cities

5.9 billion). CONCLUSIONS The large number of infections acquired by persons aged 15-24 and the high cost per case of viral STDs, particularly HIV, create a substantial economic burden.

Risk Behavior for Transmission of Human Immunodeficiency Virus (HIV) among HIV-Seropositive Individuals in an Urban Setting

Objective To estimate direct medical costs and average lifetime cost per case of pelvic inflammatory disease (PID). Methods We estimated the direct medical expenditures for PID and its three major sequelae (chronic pelvic pain, ectopic pregnancy, and infertility) and determined the average lifetime cost of a case of PID and its sequelae. We analyzed 3 years of claims data of privately insured individuals to determine costs, and 3 years of national survey data to determine number of cases of PID, chronic pelvic pain, and ectopic pregnancy. We developed a probability model to determine the average lifetime cost of a case of PID. Results Direct medical expenditures for PID and its sequelae were estimated at

Influence of human immunodeficiency virus infection on pelvic inflammatory disease.

1.88 billion in 1998:

Crack cocaine smokers who turn to drug injection: characteristics, factors associated with injection, and implications for HIV transmission

1.06 billion for PID,

STD screening of HIV-infected MSM in HIV clinics.

166 million for chronic pelvic pain,

Adherence to antiretroviral medications in an inner-city population.

295 million for ectopic pregnancy, and