Modelling the Impact of Screening Men for Chlamydia Trachomatis on the Prevalence in Women

Abstract

Chlamydia trachomatis is the most commonly reported infectious disease in the United States and causes important reproductive morbidity in women. The Centers for Disease Control and Prevention have recommended routine screening of sexually active women under age 25 but have not recommended screening among men. Consequently, untested and untreated men may serve as a reservoir of infection in women. Despite three decades of screening women, the chlamydia prevalence has continued to increase. Moreover, chlamydia is five times more common in African American (AA) youth compared to Whites, constituting an important health disparity. The Check It program is a bundled Ct intervention targeting AA men aged 15-24 who have sex with women. We created an individual-based network model to simulate a realistic chlamydia epidemic on sexual contact networks for the target population. Based on the practice in Check It, we quantified the impact of screening young AA men on the chlamydia prevalence in women. We used sensitivity analysis to quantify the relative importance of each Check It intervention component, and the significance ranked from high to low was venue-based screening, expedited index treatment, expedited partner treatment, rescreening. We estimated that by annually screening 7.5% of the target male population, the chlamydia prevalence would be reduced by 8.1% and 8.8% in men and women, respectively. The findings suggested that male-screening has the potential to significantly reduce the prevalence among women.