Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 14, 2022
Open Peer Review Period: Dec 14, 2022 - Feb 8, 2023
Date Accepted: Jun 28, 2023
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A cost-effectiveness analysis of a web-based sexual health intervention to prevent sexually transmitted infections in China
ABSTRACT
Background:
The prevention of sexually transmitted infections (STIs) in China particularly among young adults, and Chlamydia trachomatis (CT) infections are the most common STIs in young women. One of the most effective ways to prevent STIs is the consistent use of condoms during sexual intercourse. There has been no economic evaluation for an interactive web-based sexual health program, Smart Girlfriend, in China.
Objective:
To evaluate the cost-effectiveness of the Smart Girlfriend (a web-based sexual health program) to prevent sexually transmitted infections (STIs) compared with the control (a one-page information sheet about condom use) in China.
Methods:
A decision-analytical model that included a decision tree followed by a Markov structure of Chlamydia trachomatis (CT) infections was developed since CT was the most prevalent of STIs in young women. The model represents the lifetime experience following receiving the intervention and the control. The one-way and probabilistic sensitivity analyses were conducted. The main outcomes were the number of CT infections, and the incremental cost per quality-adjusted life-year (QALY).
Results:
In the base-case analysis, the introduction of the Smart Girlfriend would avert 0.45% of CT infections, 0.3% of Pelvic Inflammatory Disease, and 0.04% Chronic Pelvic Pain, resulting in a gain of 70 discounted QALYs and cost savings of 4342 USD over a 4-year time horizon, compared with the control for a cohort of 10,000 sexually active nonpregnant young women. With more than 4,548 users, the intervention would be cost-effective, and with more than 8,315 users, the intervention would be cost-saving. A 99% probability of being cost-effective was detected with a willingness to pay 17,409 USD per QALY.
Conclusions:
The Smart Girlfriend is cost-effective and possibly cost-saving. This result was particularly sensitive to the number of websites users and launching the website would be cost-effective if more than 4,548 people used it. Further work is warranted to explore if the findings could be expanded in women who have sex with women and other STIs.
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Copyright
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