Since the onset of the AIDS epidemic, the Centers for Disease Control and Prevention (CDC) has allocated several billion dollars for the prevention of HIV and other sexually transmitted diseases (STDs) in the United States. Using state-level data from 1981 to 1998, the authors found that greater amounts of prevention funding in a given year are associated with reductions in reported gonorrhea incidence rates in subsequent years. The authors conclude that funding for STD and HIV prevention, on the whole, appears to have a discernable impact on the incidence of STDs.
"To put this estimate in perspective, the annual public investment in STD prevention (federal, state, and local) in 1995 (the most current year for which estimates of combined federal, state, and local STD prevention funding are available) was about $311 million (in 2003 U.S. dollars) (Institute of Medicine, 1997). It is likely that prevention efforts have contributed to the $5.0 billion decline in STD costs (Chesson et al., 2005; Chesson, in press). Had there been no prevention efforts, STD rates could have increased since 1990. "
[Show abstract][Hide abstract] ABSTRACT: 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.
Preventive Medicine 11/2006; 43(5):411-5. DOI:10.1016/j.ypmed.2006.06.013 · 3.09 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The United States allocates more than $900 million annually for the prevention of HIV infection. We assessed the impact of this funding on HIV testing and knowledge.
We linked data from the Behavioral Risk Factor Surveillance System with tracking of Centers for Disease Control and Prevention (CDC) HIV prevention funding. We developed and validated regression models of the relation between HIV prevention funding to a respondent's state and the odds that the respondent (1) had been tested for HIV, and (2) was aware of methods to prevent mother-to-child HIV transmission (MTCT).
The odds of having been tested for HIV increased with increased CDC funding to states (P=.009), as did awareness of prevention of MTCT (P=.002). We estimate that CDC HIV prevention funds led to 12.8 million more people being tested for HIV between 1998 and 2003 than would have been tested had all states received funds equal to the lowest quintile of funding.
Federal HIV prevention funds independently correlate with increased HIV testing and knowledge of prevention of MTCT. Proposed reductions in HIV prevention spending would likely have adverse public health consequences.
American Journal of Public Health 07/2006; 96(6):1038-43. DOI:10.2105/AJPH.2005.074344 · 4.55 Impact Factor
Guowu Liu, Hongyan Lu, Juan Wang, Dongyan Xia, Yanming Sun, Guodong Mi, Liming Wang
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