From the Divisions of STD Prevention.
HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Sex Transm Dis. 2021 Apr 1;48(4):292-298. doi: 10.1097/OLQ.0000000000001358.
The purpose of this study was to estimate the number and lifetime medical cost of HIV infections attributable to incident sexually transmitted infections (STIs) in the United States in 2018.
We combined data from published models regarding the number or percentage of HIV infections attributable to STIs with updated estimates of the lifetime medical cost per HIV infection. We used 2 distinct calculation methods. Our first calculation used recent estimates of the percentage of HIV infections in men who have sex with men (MSM) attributable to gonorrhea and chlamydia. Our second calculation, based on older studies, used estimates of the expected number of STI-attributable HIV infections per new STI infection, for gonorrhea, chlamydia, syphilis, and trichomoniasis.
Our first calculation method suggested that 2489 (25th-75th percentiles, 1895-3000) HIV infections in 2018 among MSM could be attributed to gonorrhea and chlamydia, at an estimated lifetime medical cost of $1.05 billion (25th-75th percentiles, $0.79-$1.26 billion). Our second calculation method suggested that 2349 (25th-75th percentiles, 1948-2744) HIV infections in the general population (including MSM) could be attributed to chlamydia, gonorrhea, syphilis, and trichomoniasis acquired in 2018, at an estimated lifetime medical cost of $0.99 billion (25th-75th percentiles, $0.80-$1.16 billion).
Despite ambiguity regarding the degree to which STIs affect HIV transmission, our combination of data from published STI/HIV transmission models and an HIV lifetime medical cost model can help to quantify the estimated burden of STI-attributable HIV infections in the United States.
本研究旨在估计 2018 年美国因新发性传播感染（STI）而导致的 HIV 感染人数和终生医疗费用。
我们结合了有关 STI 导致 HIV 感染比例或百分比的已发表模型数据以及每例 HIV 感染终生医疗费用的最新估计值。我们使用了两种不同的计算方法。我们的第一种计算方法使用了最近关于男男性行为者（MSM）中 HIV 感染归因于淋病和衣原体的百分比的估计值。我们的第二种计算方法，基于较旧的研究，使用了每例新发 STI 感染归因于 STI 的 HIV 感染预计数量的估计值，包括淋病、衣原体、梅毒和滴虫病。
我们的第一种计算方法表明，2018 年 MSM 中可能有 2489 例（25%至 75%分位数，1895 至 3000 例）HIV 感染可归因于淋病和衣原体，估计终生医疗费用为 10.5 亿美元（25%至 75%分位数，7.90 亿至 12.60 亿美元）。我们的第二种计算方法表明，在普通人群（包括 MSM）中，2018 年可能有 2349 例（25%至 75%分位数，1948 至 2744 例）HIV 感染可归因于 2018 年获得的衣原体、淋病、梅毒和滴虫病，估计终生医疗费用为 9.9 亿美元（25%至 75%分位数，8.00 亿至 11.60 亿美元）。
尽管 STI 对 HIV 传播的影响程度存在不确定性，但我们结合了已发表的 STI/HIV 传播模型数据和 HIV 终生医疗成本模型的数据，可以帮助量化美国 STI 归因于 HIV 感染的估计负担。
