Should asymptomatic men be included in chlamydia screening programs? Cost-effectiveness of chlamydia screening among male and female entrants to a national job training program

UMMS Affiliation

Department of Pediatrics

Publication Date


Document Type



Adolescent; Adult; Chlamydia Infections; control; *Chlamydia trachomatis; Cohort Studies; Cost-Benefit Analysis; Employment; Female; Humans; Male; Mass Screening; *Patient Selection; United States; Urinalysis; Vaginal Smears




OBJECTIVE: To compare the cost-effectiveness of various chlamydia screening strategies within a population of male and female youth entering a national job training program.

STUDY DESIGN: Cost-effectiveness analysis of various chlamydia screening strategies among a cohort of 4000 female and male New England job training students. Strategies for women include (a) no screening, (b) universal endocervical DNA probe screening, (c) universal urine based NAAT screening, and (d) universal endocervical NAAT screening. Strategies for men include (a) no screening, (b) selective urine NAAT screening of leukocyte esterase (LE)-positive urines, and (c) universal urine-based NAAT screening.

RESULTS: Universal endocervical NAAT screening of women and universal urine NAAT screening of men were the most effective and cost-effective strategies individually and in combination. Endocervical NAAT screening of women prevented 23 more cases of PID and saved $27,000 more than endocervical DNA probe screening. Likewise, universal urine NAAT screening of men prevented 21 more cases of PID in their female partners and saved $16,000 more than selective urine NAAT screening of LE positive men.

CONCLUSIONS: Use of a sensitive NAAT to screen both men and women for chlamydia upon entry to a National Job Training Program is cost-effective, cost-saving, and provides a public health opportunity to substantially reduce chlamydia infections among youth at risk for sexually transmitted diseases.

DOI of Published Version



Sex Transm Dis. 2008 Jan;35(1):91-101. Link to article on publisher's website

Journal/Book/Conference Title

Sexually transmitted diseases

Related Resources

Link to Article in PubMed

PubMed ID