May 2002

Estimating the Cost and Effectiveness of Different STI Management Strategies for
Sex Workers in Madagascar

Study Methods

The investigators modeled the expected costs and benefits in terms of reduced STI prevalence of different approaches to managing STIs over a 12-month period. This model allows the user to explore “what if” questions regarding the method used to diagnose an infection and the timing of follow-up assessments for sex workers in Madagascar. Separate models were developed for syphilis, cervical infections (gonorrhea and/or chlamydia), and vaginal infections (trichomoniasis and/or bacterial vaginosis²).

To calculate the costs, the researchers estimated the value of resources used in different types of STI management, such as health practitioners’ time, supplies, laboratory tests, and drugs.

The researchers also modeled the expected reduction of STI prevalence among the sex workers using the different methods of diagnosis and various follow-up times. The probability of reinfection of sex workers with any STI was estimated on the basis of observed reinfection rates, reported sexual behavior data, the epidemiology of STIs, the effectiveness of diagnostic methods, and the effectiveness of treatments.

²Although bacterial vaginosis is an endogenous infection and not sexually transmitted, it was included as part of the modeling exercise on STI management strategies.

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03 Jan 2009