The Centers for Disease Control and Prevention recommends
annual sexually transmitted infection (STI) and HIV testing and counseling for
men who have sex with men (MSM) in the United States. We estimated the annual
total direct medical cost of providing recommended STI and HIV testing and
counseling services for MSM in the United States.
We included costs for nine STI (including anatomic
site-specific) tests recommended by the Centers for Disease Control and
Prevention (HIV, syphilis, gonorrhea, chlamydia, hepatitis B viral infection,
and herpes simplex virus type 2), office visits, and counseling. We included
nongenital tests for MSM with exposure at nongenital sites. All cost data were
obtained from the 2012 MarketScan outpatient claims database. Men were defined
as MSM if they had a male sex partner within the last 12 months, which was
estimated at 2.9% (2.6%-3.2%) of the male population in a 2012 study. All costs
were updated to 2014 US dollars.
The estimated average costs were as follows:
- HIV ($18 [$9-$27]),
- hepatitis B viral infection ($23 [$12-$35]),
- syphilis ($8 [$4-$11]),
- gonorrhea and chlamydia ($45 [$22-$67]) per anatomic site),
- herpes simplex virus type 2 ($27 [$14-$41]),
- office visit ($100 [$50-$149]),
- and counseling ($29 [$15-$44]).
We estimated that the total annual direct cost of a universal
STI and HIV testing and counseling program was $1.1 billion ($473 million-$1.7
billion) for all MSM and $756 (range, $338-$1.2 billion) when excluding office
visit cost.
These estimates provide the potential costs associated with
universal STI and HIV testing and counseling for MSM in the United States. This
information may be useful in future cost and/or cost-effectiveness analyses
that can be used to evaluate STI and HIV prevention efforts.
- 1From the Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
- More at: https://twitter.com/hiv_insight
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