{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T14:22:39Z","timestamp":1790000559401,"version":"4.0.1"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,2,18]],"date-time":"2023-02-18T00:00:00Z","timestamp":1676678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"crossref","award":["5 NU38PS004651"],"award-info":[{"award-number":["5 NU38PS004651"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Comprehensive evaluation of the quality-adjusted life-years (QALYs) lost attributable to chlamydia, gonorrhea, andtrichomoniasis in the United States is lacking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We adapted a previous probability-tree model to estimate the average number of lifetime QALYs lost due to genital chlamydia, gonorrhea, and trichomoniasis, per incident infection and at the population level, by sex and age group. We conducted multivariate sensitivity analyses to address uncertainty around key parameter values.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The estimated total discounted lifetime QALYs lost for men and women, respectively, due to infections acquired in 2018, were 1541 (95% uncertainty interval [UI], 186\u20136358) and 111 872 (95% UI, 29 777\u2013267 404) for chlamydia, 989 (95% UI, 127\u20133720) and 12 112 (95% UI, 2 410\u201333 895) for gonorrhea, and 386 (95% UI, 30\u20131851) and 4576 (95% UI, 13\u201330 355) for trichomoniasis. Total QALYs lost were highest among women aged 15\u201324 years with chlamydia. QALYs lost estimates were highly sensitive to disutilities (health losses) of infections and sequelae, and to duration of infections and chronic sequelae for chlamydia and gonorrhea in women.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The 3 sexually transmitted infections cause substantial health losses in the United States, particularly gonorrhea and chlamydia among women. The estimates of lifetime QALYs lost per infection help to prioritize prevention policies and inform cost-effectiveness analyses of sexually transmitted infection interventions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiad047","type":"journal-article","created":{"date-parts":[[2023,2,18]],"date-time":"2023-02-18T19:53:06Z","timestamp":1676749986000},"page":"1007-1018","source":"Crossref","is-referenced-by-count":31,"title":["The Estimated Lifetime Quality-Adjusted Life-Years Lost Due to Chlamydia, Gonorrhea, and Trichomoniasis in the United States in 2018"],"prefix":"10.1093","volume":"227","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6891-5392","authenticated-orcid":false,"given":"Yunfei","family":"Li","sequence":"first","affiliation":[{"name":"Department of Global Health and Population, Harvard T. H. Chan School of Public Health , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiying","family":"You","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Yale School of Public Health , New Haven, Connecticut , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0013-4733","authenticated-orcid":false,"given":"Kyueun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh , Pittsburgh, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Yaesoubi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Yale School of Public Health , New Haven, Connecticut , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Hsu","sequence":"additional","affiliation":[{"name":"Massachusetts Department of Public Health, Sexually Transmitted Disease Prevention and HIV\/AIDS Surveillance , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas L","family":"Gift","sequence":"additional","affiliation":[{"name":"Division of STD Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harrell W","family":"Chesson","sequence":"additional","affiliation":[{"name":"Division of STD Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s A","family":"Berruti","sequence":"additional","affiliation":[{"name":"Division of STD Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A","family":"Salomon","sequence":"additional","affiliation":[{"name":"Center for Health Policy\/Center for Primary Care and Outcomes Research, Stanford University , Stanford, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9292-5670","authenticated-orcid":false,"given":"Minttu M","family":"R\u00f6nn","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population, Harvard T. H. Chan School of Public Health , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,2,18]]},"reference":[{"key":"2023041817315354000_jiad047-B1","volume-title":"Sexually transmitted disease surveillance 2018","author":"Centers for Disease Control and Prevention","year":"2018"},{"key":"2023041817315354000_jiad047-B2","author":"Centers for Disease Control and Prevention"},{"key":"2023041817315354000_jiad047-B3","volume-title":"Sexually transmitted disease surveillance 2016","author":"Centers for Disease Control and Prevention","year":"2017"},{"key":"2023041817315354000_jiad047-B4","author":"Centers for Disease Control and Prevention","year":"2001"},{"key":"2023041817315354000_jiad047-B5","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1093\/cid\/cix769","article-title":"Risk of pelvic inflammatory disease in relation to chlamydia and gonorrhea testing, repeat testing, and positivity: a population-based cohort study","volume":"66","author":"Reekie","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2023041817315354000_jiad047-B6","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1097\/01.olq.0000218869.52753.c7","article-title":"The associations between pelvic inflammatory disease, trichomonas vaginalis infection, and positive herpes simplex virus type 2 serology","volume":"33","author":"Cherpes","year":"2006","journal-title":"Sex Transm Dis"},{"key":"2023041817315354000_jiad047-B7","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1097\/00007435-200110000-00005","article-title":"A systematic review of the epidemiologic interactions between classic sexually transmitted diseases and HIV: how much really is known?","volume":"28","author":"Rottingen","year":"2001","journal-title":"Sex Transm Dis"},{"key":"2023041817315354000_jiad047-B8","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1136\/sti.75.1.3","article-title":"From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection","volume":"75","author":"Fleming","year":"1999","journal-title":"Sex Transm Infect"},{"key":"2023041817315354000_jiad047-B9","volume-title":"Statpearls","author":"Schumann","year":"2022"},{"key":"2023041817315354000_jiad047-B10","doi-asserted-by":"crossref","first-page":"4362","DOI":"10.1016\/j.vaccine.2020.02.073","article-title":"Gonococcal vaccines: public health value and preferred product characteristics; report of a WHO global stakeholder consultation, January 2019","volume":"38","author":"Gottlieb","year":"2020","journal-title":"Vaccine"},{"key":"2023041817315354000_jiad047-B11","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1097\/01.AOG.0000279153.56275.b5","article-title":"Effect of noncancerous pelvic problems on health-related quality of life and sexual functioning","volume":"110","author":"Kuppermann","year":"2007","journal-title":"Obstet Gynecol"},{"key":"2023041817315354000_jiad047-B12","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1097\/OLQ.0b013e31815b07dd","article-title":"Quality of life utilities for pelvic inflammatory disease health states","volume":"35","author":"Smith","year":"2008","journal-title":"Sex Transm Dis"},{"key":"2023041817315354000_jiad047-B13","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1016\/j.fertnstert.2003.09.064","article-title":"Preferences for fertility in women with pelvic inflammatory disease","volume":"81","author":"Songer","year":"2004","journal-title":"Fertil Steril"},{"key":"2023041817315354000_jiad047-B14","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1136\/sextrans-2011-050187","article-title":"Adolescent and parental utilities for the health states associated with pelvic inflammatory disease","volume":"87","author":"Trent","year":"2011","journal-title":"Sex Transm Infect"},{"key":"2023041817315354000_jiad047-B15","volume-title":"Vaccines for the 21st century: A tool for decision making","author":"Institute of Medicine (US) Committee to Study Priorities for Vaccine Development","year":"2000"},{"key":"2023041817315354000_jiad047-B16","first-page":"100364","article-title":"Estimated costs and quality-adjusted life-years lost due to N. gonorrhoeae infections acquired in 2015 in the United States: a modelling study of overall burden and disparities by age, race\/ethnicity, and other factors","volume":"16","author":"Li","year":"2022","journal-title":"Lancet Reg Health Am"},{"key":"2023041817315354000_jiad047-B17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr7004a1","article-title":"Sexually transmitted infections treatment guidelines, 2021","volume":"70","author":"Workowski","year":"2021","journal-title":"MMWR Recomm Rep"},{"key":"2023041817315354000_jiad047-B18","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1097\/01.olq.0000154501.22566.fa","article-title":"The cost effectiveness of gonorrhea screening in urban emergency departments","volume":"32","author":"Aledort","year":"2005","journal-title":"Sex Transm Dis"},{"key":"2023041817315354000_jiad047-B19","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1097\/OLQ.0b013e31824717ae","article-title":"Estimation of the burden of disease and costs of genital Chlamydia trachomatis infection in Canada","volume":"39","author":"Tuite","year":"2012","journal-title":"Sex Transm Dis"},{"key":"2023041817315354000_jiad047-B20","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1097\/OLQ.0000000000001382","article-title":"Estimates of the prevalence and incidence of chlamydia and gonorrhea among US men and women, 2018","volume":"48","author":"Kreisel","year":"2021","journal-title":"Sex Transm Dis"},{"key":"2023041817315354000_jiad047-B21","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1097\/OLQ.0000000000001383","article-title":"Incidence and prevalence of trichomonas vaginalis infection among persons aged 15 to 59 years: United States, 2018","volume":"48","author":"Lewis","year":"2021","journal-title":"Sex Transm Dis"},{"key":"2023041817315354000_jiad047-B22","first-page":"322","article-title":"Asymptomatic urethral gonorrhoea in men","volume":"54","author":"John","year":"1978","journal-title":"Br J Vener Dis"},{"key":"2023041817315354000_jiad047-B23","volume-title":"Global burden of disease study 2019 (GBD 2019) disability weights","author":"Global Burden of Disease Collaborative Network","year":"2020"},{"key":"2023041817315354000_jiad047-B24","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1177\/0272989X06290495","article-title":"Preference-based EQ-5D index scores for chronic conditions in the United States","volume":"26","author":"Sullivan","year":"2006","journal-title":"Med Decis Making"},{"key":"2023041817315354000_jiad047-B25","volume-title":"United States life tables, 2018","author":"Arias","year":"2020"},{"key":"2023041817315354000_jiad047-B26","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1038\/3218","article-title":"The global burden of disease, 1990\u20132020","volume":"4","author":"Lopez","year":"1998","journal-title":"Nat Med"},{"key":"2023041817315354000_jiad047-B27","author":"US Census Bureau"},{"key":"2023041817315354000_jiad047-B28","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1097\/OLQ.0000000000001357","article-title":"The estimated lifetime medical cost of chlamydia, gonorrhea, and trichomoniasis in the United States 2018","volume":"48","author":"Kumar","year":"2021","journal-title":"Sex Transm Dis"},{"key":"2023041817315354000_jiad047-B29","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1097\/OLQ.0b013e318285c6d2","article-title":"The estimated direct medical cost of selected sexually transmitted infections in the United States 2008","volume":"40","author":"Owusu-Edusei","year":"2013","journal-title":"Sex Transm Dis"},{"key":"2023041817315354000_jiad047-B30","doi-asserted-by":"crossref","first-page":"e020394","DOI":"10.1136\/bmjopen-2017-020394","article-title":"Modelling-based evaluation of the costs, benefits and cost-effectiveness of multipathogen point-of-care tests for sexually transmitted infections in symptomatic genitourinary medicine clinic attendees","volume":"8","author":"Huntington","year":"2018","journal-title":"BMJ Open"},{"key":"2023041817315354000_jiad047-B31","doi-asserted-by":"crossref","first-page":"e810","DOI":"10.1093\/cid\/ciac427","article-title":"Estimation of the lifetime quality-adjusted life years (QALYs) lost due to syphilis acquired in the United States in 2018","volume":"76","author":"Lee","year":"2023","journal-title":"Clin Infect Dis"},{"key":"2023041817315354000_jiad047-B32","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1186\/1471-2458-6-177","article-title":"WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity","volume":"6","author":"Latthe","year":"2006","journal-title":"BMC Public Health"},{"key":"2023041817315354000_jiad047-B33","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1093\/infdis\/158.3.510","article-title":"Etiology and outcome of acute pelvic inflammatory disease","volume":"158","author":"Brunham","year":"1988","journal-title":"J Infect Dis"},{"key":"2023041817315354000_jiad047-B34","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1258\/095646205774763270","article-title":"A review on pelvic inflammatory disease","volume":"16","author":"Barrett","year":"2005","journal-title":"Int J STD AIDS"},{"key":"2023041817315354000_jiad047-B35","doi-asserted-by":"crossref","first-page":"2581","DOI":"10.1001\/jama.1991.03470180081042","article-title":"Assessing risk for pelvic inflammatory disease and its sequelae","volume":"266","author":"Washington","year":"1991","journal-title":"JAMA"},{"key":"2023041817315354000_jiad047-B36","author":"Tu"},{"key":"2023041817315354000_jiad047-B37","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.midw.2012.02.001","article-title":"\u2018Let men into the pregnancy\u2019\u2014men's perceptions about being tested for chlamydia and HIV during pregnancy","volume":"29","author":"Christianson","year":"2013","journal-title":"Midwifery"},{"key":"2023041817315354000_jiad047-B38","doi-asserted-by":"crossref","first-page":"S66","DOI":"10.1097\/OLQ.0b013e31818b64ac","article-title":"The program cost and cost-effectiveness of screening men for chlamydia to prevent pelvic inflammatory disease in women","volume":"35","author":"Gift","year":"2008","journal-title":"Sex Transm Dis"},{"key":"2023041817315354000_jiad047-B39","doi-asserted-by":"crossref","first-page":"S51","DOI":"10.1097\/OLQ.0b013e3181723dba","article-title":"The cost-effectiveness of screening men for Chlamydia trachomatis: a review of the literature","volume":"35","author":"Gift","year":"2008","journal-title":"Sex Transm Dis"},{"key":"2023041817315354000_jiad047-B40","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1097\/OLQ.0b013e3181dd1691","article-title":"A randomized controlled trial of partner notification methods for prevention of trichomoniasis in women","volume":"37","author":"Schwebke","year":"2010","journal-title":"Sex Transm Dis"},{"key":"2023041817315354000_jiad047-B41","doi-asserted-by":"crossref","first-page":"e1001777","DOI":"10.1371\/journal.pmed.1001777","article-title":"Uptake and population-level impact of expedited partner therapy (EPT) on Chlamydia trachomatis and Neisseria gonorrhoeae: the Washington State community-level randomized trial of EPT","volume":"12","author":"Golden","year":"2015","journal-title":"PLoS Med"},{"key":"2023041817315354000_jiad047-B42","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1056\/NEJMoa041681","article-title":"Effect of expedited treatment of sex partners on recurrent or persistent gonorrhea or chlamydial infection","volume":"352","author":"Golden","year":"2005","journal-title":"N Engl J Med"},{"key":"2023041817315354000_jiad047-B43","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s12963-014-0020-2","article-title":"Review of disability weight studies: comparison of methodological choices and values","volume":"12","author":"Haagsma","year":"2014","journal-title":"Popul Health Metr"},{"key":"2023041817315354000_jiad047-B44","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1136\/sextrans-2019-053999","article-title":"Pregnancy and fertility-related adverse outcomes associated with Chlamydia trachomatis infection: a global systematic review and meta-analysis","volume":"96","author":"Tang","year":"2020","journal-title":"Sex Transm Infect"},{"key":"2023041817315354000_jiad047-B45","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1097\/OLQ.0000000000000878","article-title":"Repeat chlamydia diagnoses increase the hazard of pelvic inflammatory disease among US army women: a retrospective cohort analysis","volume":"45","author":"Bautista","year":"2018","journal-title":"Sex Transm Dis"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jid\/advance-article-pdf\/doi\/10.1093\/infdis\/jiad047\/49689392\/jiad047.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/227\/8\/1007\/50013519\/jiad047.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/227\/8\/1007\/50013519\/jiad047.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T17:52:17Z","timestamp":1681840337000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/article\/227\/8\/1007\/7046023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,18]]},"references-count":45,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,2,18]]},"published-print":{"date-parts":[[2023,4,18]]}},"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiad047","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"value":"0022-1899","type":"print"},{"value":"1537-6613","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,4,15]]},"published":{"date-parts":[[2023,2,18]]}}}