{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T03:02:22Z","timestamp":1789959742828,"version":"4.0.1"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"9","funder":[{"DOI":"10.13039\/100000030","name":"US Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Center for HIV"},{"name":"Viral Hepatitis"},{"DOI":"10.13039\/100028472","name":"STD","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100028472","id-type":"DOI","asserted-by":"publisher"}]},{"name":"TB Prevention (Epidemiologic and Economic Modeling Agreement","award":["NU38PS004651"],"award-info":[{"award-number":["NU38PS004651"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Estimates of chlamydia and gonorrhea prevalence and incidence have typically focused on national-level epidemiology. Disaggregated estimates are useful for local public health decision making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed a bayesian hierarchical modeling framework to estimate the incidence and prevalence of chlamydia and gonorrhea for women in the United States. The model was calibrated to indicators from different data sources, including state- and age-specific laboratory test positivity (data pooled over 2019\u20132023) and diagnosis rates (average of 2019\u20132023). At the national level, we calibrated to chlamydia prevalence and test coverage. We used the model to estimate state- and national-level prevalence, incidence, and screening rates among women by state and age (15\u201324, 25\u201334, 35\u201344, 45\u201354, \u226555 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For women aged 15 to 24 years, national-level chlamydia prevalence was estimated at 4.6% (95% uncertainty interval, 4.2%\u20134.9%), gonorrhea prevalence was 0.4% (0.4%\u20130.5%), and testing coverage was 33.4% (33.1%\u201333.7%). Across states, corresponding chlamydia incidence estimates were 1.9 to 3.1 times as high as observed diagnosis rates; gonorrhea incidence estimates were 3.3 to 4.7 times as high as diagnosis rates. Chlamydia prevalence in women aged 15 to 24 years ranged from 2.3% to 7.8% across states, and chlamydia incidence ranged from 2.8% to 12.4%. Gonorrhea prevalence ranged from 0.09% to 1%, and gonorrhea incidence ranged from 0.5% to 6.0%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study presents a new analytic framework for estimating incidence and prevalence at the state level. By integrating laboratory, diagnosis, and survey data, we provide more granular, actionable estimates of sexually transmitted infection burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag567","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:09:28Z","timestamp":1788354568000},"source":"Crossref","is-referenced-by-count":0,"title":["Estimating State-Level Chlamydia and Gonorrhea Incidence and Prevalence Among Women in the United States, 2019\u20132023: Mathematical Modeling Analysis"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9292-5670","authenticated-orcid":false,"given":"Minttu M","family":"R\u00f6nn","sequence":"first","affiliation":[{"name":"Department of Global Health and Population, Harvard T.H. Chan School of Public Health , Boston, Massachusetts ,","place":["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 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4104-2584","authenticated-orcid":false,"given":"Michelle","family":"Bronsard","sequence":"additional","affiliation":[{"name":"Department of Health Policy, Stanford University , Stanford, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoyu","family":"Tao","sequence":"additional","affiliation":[{"name":"Division of STD Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3929-5515","authenticated-orcid":false,"given":"Joshua A","family":"Salomon","sequence":"additional","affiliation":[{"name":"Department of Health Policy, Stanford University , Stanford, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"2026092022213356400_ofag567-B1","author":"Centers for Disease Control and Prevention"},{"key":"2026092022213356400_ofag567-B2","author":"Centers for Disease Control and Prevention"},{"key":"2026092022213356400_ofag567-B3","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1001\/jama.2021.14081","article-title":"Screening for chlamydia and gonorrhea: US Preventive Services Task Force recommendation statement","volume":"326","author":"Davidson","year":"2021","journal-title":"JAMA"},{"key":"2026092022213356400_ofag567-B4","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1093\/infdis\/jiad047","article-title":"The estimated lifetime quality-adjusted life-years lost due to chlamydia, gonorrhea, and trichomoniasis in the United States in 2018","volume":"227","author":"Li","year":"2023","journal-title":"J Infect Dis"},{"key":"2026092022213356400_ofag567-B5","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/OLQ.0b013e318286bb53","article-title":"Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008","volume":"40","author":"Satterwhite","year":"2013","journal-title":"Sex Transm Dis"},{"key":"2026092022213356400_ofag567-B6","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1097\/OLQ.0000000000001763","article-title":"Estimated incidence and prevalence of gonorrhea in the United States, 2006\u20132019","volume":"50","author":"Pollock","year":"2023","journal-title":"Sex Transm Dis"},{"key":"2026092022213356400_ofag567-B7","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1097\/OLQ.0b013e31827c5a71","article-title":"Prevalence of Neisseria gonorrhoeae among persons 14 to 39 years of age, United States, 1999 to 2008","volume":"40","author":"Torrone","year":"2013","journal-title":"Sex Transm Dis"},{"key":"2026092022213356400_ofag567-B8","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":"2026092022213356400_ofag567-B9","doi-asserted-by":"crossref","DOI":"10.1093\/aje\/kwy272","article-title":"The impact of screening and partner notification on chlamydia in the United States, 2000 to 2015: evaluation of epidemiological trends 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\u201ceight Americas.\u201d","volume":"39","author":"Chesson","year":"2012","journal-title":"Sex Transm Dis"},{"key":"2026092022213356400_ofag567-B13","author":"Stan Development Team"},{"key":"2026092022213356400_ofag567-B14","author":"National Committee for Quality Assurance"},{"key":"2026092022213356400_ofag567-B15","author":"Centers for Disease Control and Prevention"},{"key":"2026092022213356400_ofag567-B16","author":"Centers for Disease Control and Prevention"},{"key":"2026092022213356400_ofag567-B17","author":"National Center for Health Statistics"},{"key":"2026092022213356400_ofag567-B18","unstructured":"Stanford Center for Population Health Sciences . Medicaid 100% [2011\u20132019]. Dataset. Redivis. Available at: https:\/\/redivis.com\/StanfordPHS. 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