Article Text

Download PDFPDF
Influence of epidemic phase on the cost effectiveness of a prevention intervention for sexually transmitted infection: an exploratory analysis
  1. Harrell W Chesson1,
  2. Peter J White2
  1. 1Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  2. 2Department of Infectious Disease Epidemiology, Imperial College Faculty of Medicine, London, UK
  1. Correspondence to:
 Harrell Chesson
 Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-80, Atlanta, GA 30333; hchesson{at}


Objectives: To explore how the cost effectiveness of a behaviour-change prevention programme for sexually transmitted infection (STI) varies with the phase of an STI epidemic.

Methods: A model of STI transmission and standard methods of cost-effectiveness analysis was used to examine the cost effectiveness of a hypothetical, behaviour-change intervention initiated at various phases of an STI epidemic.

Results: The intervention was more cost effective when initiated in earlier phases of the epidemic rather than later phases, under a range of scenarios. However, the relative impact of the timing of the initiation of the STI prevention intervention on the cost effectiveness was quite small compared with other important factors, such as the cost and impact of the intervention and the lifetime medical cost of the STI.

Conclusions: Earlier initiation of an intervention can improve the cost effectiveness of the intervention, although this result does not hold for all possible scenarios.

  • cost-effectiveness
  • prevention
  • sexually transmitted diseases

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Published Online First 21 February 2007

  • Competing interests: None.

  • The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

  • Edited by: Sevgi O Aral and James Blanchard