Chesson Harrell W, Gift Thomas L, Pulver Amy L S
Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, CDC Mailstop E-80, 1600 Clifton Road, Atlanta, GA 30333, USA.
Prev Med. 2006 Nov;43(5):411-5. doi: 10.1016/j.ypmed.2006.06.013. Epub 2006 Aug 8.
Prevention efforts can reduce the considerable health and economic burdens imposed by sexually transmitted diseases (STDs). The objective of this study was to estimate the reduction in direct medical costs associated with reductions in gonorrhea and syphilis incidence in the United States from 1990 to 2003.
Using published estimates of the per-case costs of STDs, we estimated the annual costs from 1990 to 2003 of four main outcomes: primary and secondary (P&S) syphilis, congenital syphilis, gonorrhea, and HIV costs attributable to the facilitative effects of gonorrhea and syphilis on HIV transmission and acquisition.
Reductions in syphilis and gonorrhea from 1990 to 2003 have saved an estimated 5.0 billion dollars (in 2003 U.S. dollars): 1.1 billion dollars in costs associated with P&S syphilis, congenital syphilis, and gonorrhea, and 3.9 billion dollars in HIV costs attributable to syphilis and gonorrhea. In additional analyses, the estimated reductions in disease burden were substantially lower (1) when calculated incrementally (rather than cumulatively) and (2) when long-term costs of STDs were excluded.
These estimated reductions in the burden of gonorrhea and syphilis show the economic benefits of reducing the incidence of these STDs and preventing their resurgence.
预防措施可减轻性传播疾病（STD）带来的巨大健康和经济负担。本研究的目的是估计1990年至2003年美国淋病和梅毒发病率降低所带来的直接医疗成本的减少。
利用已发表的性传播疾病单病例成本估计值，我们估计了1990年至2003年四种主要结果的年度成本：一期和二期（P&S）梅毒、先天性梅毒、淋病，以及由于淋病和梅毒对艾滋病毒传播和感染的促进作用而产生的艾滋病毒成本。
1990年至2003年梅毒和淋病发病率的降低估计节省了50亿美元（2003年美元）：11亿美元用于一期和二期梅毒、先天性梅毒和淋病相关的成本，39亿美元用于梅毒和淋病导致的艾滋病毒成本。在进一步的分析中，（1）当按增量（而非累积）计算时，以及（2）当排除性传播疾病的长期成本时，估计的疾病负担降低幅度要低得多。
淋病和梅毒负担的这些估计降低表明了降低这些性传播疾病发病率并防止其卷土重来的经济效益。
