Institutional members access full text with Ovid®

Share this article on:

Methods for Sexually Transmitted Disease Prevention Programs to Estimate the Health and Medical Cost Impact of Changes in Their Budget

Chesson, Harrell, W., PhD; Ludovic, Jennifer, A., DrPH, MPH; Berruti, Andrés, A., PhD; Gift, Thomas, L., PhD

Sexually Transmitted Diseases: January 2018 - Volume 45 - Issue 1 - p 2–7
doi: 10.1097/OLQ.0000000000000747
Original Studies

Background The purpose of this article was to describe methods that sexually transmitted disease (STD) programs can use to estimate the potential effects of changes in their budgets in terms of disease burden and direct medical costs.

Methods We proposed 2 distinct approaches to estimate the potential effect of changes in funding on subsequent STD burden, one based on an analysis of state-level STD prevention funding and gonorrhea case rates and one based on analyses of the effect of Disease Intervention Specialist (DIS) activities on gonorrhea case rates. We also illustrated how programs can estimate the impact of budget changes on intermediate outcomes, such as partner services. Finally, we provided an example of the application of these methods for a hypothetical state STD prevention program.

Results The methods we proposed can provide general approximations of how a change in STD prevention funding might affect the level of STD prevention services provided, STD incidence rates, and the direct medical cost burden of STDs. In applying these methods to a hypothetical state, a reduction in annual funding of US $200,000 was estimated to lead to subsequent increases in STDs of 1.6% to 3.6%. Over 10 years, the reduction in funding totaled US $2.0 million, whereas the cumulative, additional direct medical costs of the increase in STDs totaled US $3.7 to US $8.4 million.

Conclusions The methods we proposed, though subject to important limitations, can allow STD prevention personnel to calculate evidence-based estimates of the effects of changes in their budget.

We describe methods that sexually transmitted disease (STD) programs can use to estimate the potential impact of changes in their budgets, including changes in STD services provided, STD incidence rates, and STD costs.

From the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA

Conflict of Interest and Sources of Funding: None declared.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.

Correspondence: Harrell W. Chesson, PhD, CDC Mailstop E-80, 1600 Clifton Road, Atlanta, GA 30329. E-mail:

Received for publication August 4, 2017, and accepted October 15, 2017.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (

© Copyright 2018 American Sexually Transmitted Diseases Association