The economic cost of private behaviour between consenting adults

What is done in private between consenting individuals  is  no body’s business  but  their  own”   ?


The following  is  from the  Centers  for  Disease  Control   at :

STD Trends in the United States: 2010 National Data for Gonorrhea, Chlamydia, and Syphilis

This document summarizes 2010 national data on gonorrhea, chlamydia, and syphilis that are published in CDC’s report, Sexually Transmitted Disease Surveillance, 2010. The data are based on state and local STD case reports from a variety of private and public sources, the majority of which come from non-STD clinic settings, such as private physician offices and health maintenance organizations.

19 Million

STDs are one of the most critical health challenges facing the nation today. CDC estimates that there are 19 million new infections every year in the United States.

$17 Billion

STDs cost the U.S. health care system $17 billion every year—and cost individuals even more in immediate and life-long health consequences.

CDC’s surveillance report includes data on the three STDs that physicians are required to report to local or state public health authorities—gonorrhea, chlamydia, and syphilis—which represent only a fraction of the true burden of STDs. Some common STDs, like human papillomavirus (HPV) and genital herpes, are not required to be reported.

The latest CDC data show troubling trends in three treatable STDs:

  • Gonorrhea: While reported rates are at historically low levels, cases increased slightly from last year and more than 300,000 cases were reported in 2010. There are also signs from other CDC surveillance systems that the disease may become resistant to the only available treatment option.
  • Chlamydia: Case reports have been increasing steadily over the past 20 years, and in 2010, 1.3 million chlamydia cases were reported. While the increase is due to expanded screening efforts, and not to an actual increase in the number of people with chlamydia, a majority of infections still go undiagnosed. Less than half of sexually active young women are screened annually as recommended by CDC.
  • Syphilis: The overall syphilis rate decreased for the first time in a decade, and is down 1.6 percent since 2009. However, the rate among young black men has increased dramatically over the past five years (134 percent). Other CDC data also show a significant increase in syphilis among young black men who have sex with men (MSM), suggesting that new infections among MSM are driving the increase in young black men. The finding is particularly concerning as there has also been a sharp increase in HIV infections among this population.


Perspect Sex Reprod Health. 2004 Jan-Feb;36(1):11-9.

The estimated direct medical cost of sexually transmitted diseases among American youth, 2000.

Chesson HW, Blandford JM, Gift TL, Tao G, Irwin KL.


Health Services Research and Evaluation Branch, Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.



Each year, millions of U.S. youth acquire sexually transmitted diseases (STDs). Estimates of the economic burden of STDs can help to quantify the impact of STDs on the nation’s youth and on the payers of the cost of their medical care.


We synthesized the existing literature on STD costs to estimate the lifetime medical cost per case of eight major STDs-HIV, human papillomavirus (HPV), genital herpes simplex virus type 2, hepatitis B, chlamydia, gonorrhea, trichomoniasis and syphilis. We then estimated the total burden of disease by multiplying these cost-per-case estimates by the approximate number of new cases of STDs acquired by youth aged 15-24.


The total estimated burden of the nine million new cases of these STDs that occurred among 15-24-year-olds in 2000 was $6.5 billion (in year 2000 dollars). Viral STDs accounted for 94% of the total burden ($6.2 billion), and nonviral STDs accounted for 6% of the total burden ($0.4 billion). HIV and HPV were by far the most costly STDs in terms of total estimated direct medical costs, accounting for 90% of the total burden ($5.9 billion).


The large number of infections acquired by persons aged 15-24 and the high cost per case of viral STDs, particularly HIV, create a substantial economic burden.



13 November 2010 – Volume 24 – Issue 17 – p 2705–2715

doi: 10.1097/QAD.0b013e32833f3c14

Epidemiology and Social

Contemporary costs of HIV healthcare in the HAART era

Gebo, Kelly Aa; Fleishman, John Ab; Conviser, Richardc; Hellinger, Jamesd; Hellinger, Fred Jb; Josephs, Joshua Sa; Keiser, Philipe; Gaist, Paulf; Moore, Richard Da; for the HIV Research Network


Background: The delivery of HIV healthcare historically has been expensive. The most recent national data regarding HIV healthcare costs were from 1996–1998. We provide updated estimates of expenditures for HIV management.

Methods: We performed a cross-sectional review of medical records at 10 sites in the HIV Research Network, a consortium of high-volume HIV care providers across the United States. We assessed inpatient days, outpatient visits, and prescribed antiretroviral and opportunistic illness prophylaxis medications for 14 691 adult HIV-infected patients in primary HIV care in 2006. We estimated total care expenditures, stratified by the median CD4 cell count obtained in 2006 (≤50, 51–200, 201–350, 351–500, >500 cells/μl). Per-unit costs of care were based on Healthcare Cost and Utilization Project (HCUP) data for inpatient care, discounted average wholesale prices for medications, and Medicare physician fees for outpatient care.

Results: Averaging over all CD4 strata, the mean annual total expenditures per person for HIV care in 2006 in three sites was US $19 912, with an interquartile range from US $11 045 to 22 626. Average annual per-person expenditures for care were greatest for those with CD4 cell counts 50 cell/μl or less (US $40 678) and lowest for those with CD4 cell counts more than 500 cells/μl (US $16 614). The majority of costs were attributable to medications, except for those with CD4 cell counts 50 cells/μl or less, for whom inpatient costs were highest.

Conclusion: HIV healthcare in the United States continues to be expensive, with the majority of expenditures attributable to medications. With improved HIV survival, costs may increase and should be monitored in the future.

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