{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:47:45Z","timestamp":1791920865776,"version":"4.3.4"},"reference-count":29,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2020,12,6]]},"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Pre-exposure prophylaxis (PrEP) users are routinely tested four times a year (3\u2009monthly) for asymptomatic<jats:italic>Chlamydia trachomatis<\/jats:italic>(CT) and<jats:italic>Neisseria gonorrhoeae<\/jats:italic>(NG) infections on three anatomical locations. Given the high costs of this testing to the PrEP programme, we assessed the impact of 3\u2009monthly screening(current practice), compared with 6\u2009monthly on the disease burden. We quantified the difference in impact of these two testing frequencies on the prevalence of CT and NG among all men who have sex with men (MSM) who are at risk of an STI, and explored the cost-effectiveness of 3-monthly screening compared with a baseline scenario of 6-monthly screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A dynamic infection model was developed to simulate the transmission of CT and NG among sexually active MSM (6500 MSM on PrEP and 29\u2009531 MSM not on PrEP), and the impact of two different test frequencies over a 10-year period. The difference in number of averted infections was used to calculate incremental costs and quality-adjusted life-years (QALY) as well as an incremental cost-effectiveness ratio (ICER) from a societal perspective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with 6-monthly screening, 3-monthly screening of PrEP users for CT and NG cost an additional \u20ac46.8 million over a period of 10 years. Both screening frequencies would significantly reduce the prevalence of CT and NG, but 3-monthly screening would avert and extra ~18\u2009250\u2009CT and NG infections compared with 6-monthly screening, resulting in a gain of ~81 QALYs. The corresponding ICER was ~\u20ac430\u2009000 per QALY gained, which exceeded the cost-effectiveness threshold of \u20ac20\u2009000 per QALY.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Three-monthly screening for CT and NG among MSM on PrEP is not cost-effective compared with 6-monthly screening. The ICER becomes more favourable when a smaller fraction of all MSM at risk for an STI are screened. Reducing the screening frequency could be considered when the PrEP programme is established and the prevalence of CT and NG decline.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2020-054741","type":"journal-article","created":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T23:00:11Z","timestamp":1610492411000},"page":"607-612","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Cost-effectiveness of two screening strategies for<i>Chlamydia trachomatis<\/i>and<i>Neisseria gonorrhoeae<\/i>as part of the PrEP programme in the Netherlands: a modelling study"],"prefix":"10.1136","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6891-6678","authenticated-orcid":false,"given":"Francine","family":"van Wifferen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0512-2109","authenticated-orcid":false,"given":"Elske","family":"Hoornenborg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten F","family":"Schim van der Loeff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janneke","family":"Heijne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert Jan","family":"van Hoek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,11]]},"reference":[{"key":"2024092104000847000_97.8.607.1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001145"},{"key":"2024092104000847000_97.8.607.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00056-2"},{"key":"2024092104000847000_97.8.607.3","unstructured":"Aribas J , Marzolini C , Mallon P , et al . 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Available: https:\/\/www.rijksoverheid.nl\/binaries\/rijksoverheid\/documenten\/rapporten\/2019\/02\/06\/implementatie-prep-verstrekking-en-medische-begeleiding-in-nederland\/implementatie-prep-verstrekking-en-medische-begeleiding-in-nederland.pdf"},{"key":"2024092104000847000_97.8.607.6","doi-asserted-by":"publisher","DOI":"10.1086\/430704"},{"key":"2024092104000847000_97.8.607.7","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1093\/cid\/ciy048","article-title":"Risks of antimicrobial resistance in N. gonorrhoeae associated with intensive screening programs in pre-exposure prophylaxis programs","volume":"67","author":"Kenyon","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2024092104000847000_97.8.607.8","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1093\/cid\/ciz510","article-title":"Optimizing strategies for Chlamydia trachomatis and Neisseria gonorrhoeae screening in men who have sex with men: a modeling study","volume":"70","author":"Voirin","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2024092104000847000_97.8.607.9","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix439"},{"key":"2024092104000847000_97.8.607.10","unstructured":"Bruins B . 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