The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #70932

K. John McConnell, PhD, Center for Policy and Research in Emergency Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, 503-494-1989, mcconnjo@ohsu.edu, Antonia Biggs, PhD, Center for Reproductive Health Research and Policy, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94143-0936, JM Chow, DrPH, Sexually Transmitted Disease Control Branch, CA DHS, UCSF Center for Reproductive Health Research and Policy, 1947 Center Street, Suite 201, Berkeley, CA 84704, Claire Brindis, DrPH, Center for Reproductive Health Research and Policy, University of California at San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94143-0936, and Anna Ramirez, MPH, Office of Family Planning, State of California Department of Health Services, 714 P Street #440, Sacramento, CA 95814.

Many men experience asymptomatic chlamydial infections, which often remain untreated and eventually contribute to infections in women. Screening men for such infections may prevent the spread of infection and possible reinfection in men and women alike. Previous studies have shown that chlamydia screening may be cost-effective in men when the effect on a potential partner is included. However, these studies have typically not considered the effect of reinfection, which is an important consideration. First, it will reduce the overall cost-effectiveness of any screening program. Second, modeling the potential for reinfection underlines the importance of male screening and Partner Delivered Therapy (PDT). The effectiveness of any treatment program is attenuated when it does not include strategies aimed at eliminating asymptomatic infections in partners. We developed a decision analytic model to evaluate the cost-effectiveness of several policy options, mainly screening, testing, and treating males for chlamydia, with and without PDT, incorporating the costs associated with the transmission of chlamydia infections to female partners. Assuming a prevalence of 10%, programs that screen males and incorporate some level of partner management are cost-effective when compared to a policy of no treatment. For each policy, more aggressive partner management results in fewer cases of chlamydia and is always more cost-effective.

Learning Objectives:

• 1. Identify the risks and costs of chlamydia and the benefits of a screening program targeted to males.
• 2. Describe the benefits of Partner Delivered Therapy (PDT)
• 3. Understand how to address issues of uncertainty and reinfection in a screening model.

Keywords: Cost-Effectiveness, Chlamydia

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.