The Expected Lifetime Cost of Chlamydia and Gonorrhea per Infant Born in the United States

Background: Recent estimates suggest that approximately 20 million cases of STIs occurred in the United States in 2008, with lifetime costs of $17.5 billion (2014 US dollars), including the costs of HIV.  Although the substantial health and economic burden of STIs has been well-documented, no estimates exist regarding the expected lifetime costs of STIs that will be incurred by the average infant born today in the US.

Methods: We calculated the expected, discounted lifetime costs of chlamydia and gonorrhea for newborn males and females.  We applied annual incidence rates for two age groups (15 to 24 years and 25 to 39 years) based on published estimates of STI incidence in 2008 in the US.  We obtained cost per case estimates from the literature ($34 and $408 for chlamydia in men and women, respectively, and $89 and $397 for gonorrhea in men and women, respectively, in 2014 US dollars). Future costs were discounted at 3% annually. 

Results: There were an estimated 33.9 lifetime chlamydia cases and 9.9 lifetime gonorrhea cases per 100 newborns, which includes the possibility of multiple infections over a lifetime.  The expected discounted lifetime cost per newborn female was $131 for chlamydia and $36 for gonorrhea.  The expected discounted lifetime cost per newborn male was $12 for chlamydia and $10 for gonorrhea. 

Conclusions:  The expected lifetime cost for chlamydia and gonorrhea for a newborn baby in the US is approximately $95 ($22 for males, $167 for females).  The actual lifetime burden could be notably higher or lower than we estimated if incidence rates or costs change in the future.  Future research is needed to estimate the lifetime costs of other STIs in order to generate a more comprehensive estimate of the total expected lifetime burden of STIs per infant born in the US.