Predicting the impact of sexual behavior change on adolescent STI in the US and New York State: a case study of the teen-SPARC tool

• Type of Material: Article
• Authors: Steven M Goodreau, University of Washington; Emily D Pollock, University of Washington; Li Yan Wang, Centers for Disease Control and Prevention, Atlanta; Lisa C Barrios, Centers for Disease Control and Prevention, Atlanta; Richard L Dunville, Centers for Disease Control and Prevention, Atlanta; Maria V Aslam, Centers for Disease Control and Prevention, Atlanta; David A Katz, University of Washington; Rachel Hart-Malloy, New York State Department of Health; Elizabeth M Rosenthal, State University of New York; Monica Trigg, Emory University; Megan Fields, Emory University; Deven T Hamilton, University of Washington; Eli Rosenberg, Emory University
• Language: English
• Date: 2020-07-01
• Publisher: ELSEVIER SCIENCE INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.annepidem.2020.05.009
• Title of Journal or Parent Work: ANNALS OF EPIDEMIOLOGY
• Volume: 47
• Start Page: 13
• End Page: 18
• Grant/Funding Information: This work was supported by the U.S. Centers for Disease Control and Prevention’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention [cooperative agreement U38-PS004646]. Additional support was provided by the University of Washington/Fred Hutch Center for AIDS Research, an NIH-funded program [grant number P30 AI027757]; and by a research infrastructure grant from NICHD to the UW Center for Studies in Demography and Ecology [grant number P2C HD042828]. CDC scientist coauthors were involved in the study design, interpretation of results, and writing of the manuscript. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
• Keywords: Sexual behavior; Adolescents; Gonorrhea (epidemiology); EDUCATION; Chlamydia infections (epidemiology); PREGNANCY; Mathematical model; INTERVENTIONS; Public, Environmental & Occupational Health; United States; Science & Technology; HIV-1 (epidemiology); Life Sciences & Biomedicine; TRANSMITTED INFECTIONS

Abstract

Purpose: Adolescents aged 13–18 years bear a large burden of sexually transmitted infections (STIs) and changing adolescent sexual risk behavior is a key component of reducing this burden. We demonstrate a novel publicly available modeling tool (teen-SPARC) to help state and local health departments predict the impact of behavioral change on gonorrhea, chlamydia, and HIV burden among adolescents. Methods: Teen-SPARC is built in Excel for familiarity and ease and parameterized using data from CDC's Youth Risk Behavior Surveillance System. We present teen-SPARC's methods, including derivation of national parameters and instructions to obtain local parameters. We model multiple scenarios of increasing condom use and estimate the impact on gonorrhea, chlamydia, and HIV incidence, comparing national and New York State (NYS) results. Results: A 1% annual increase in condom use (consistent with Healthy People 2020 goals) could prevent nearly 10,000 cases of STIs nationwide. Increases in condom use of 17.1%, 2.2%, and 25.5% in NYS would be necessary to avert 1000 cases of gonorrhea, 1000 cases of chlamydia, and 10 cases of HIV infection, respectively. Additional results disaggregate outcomes by age, sex, partner sex, jurisdiction, and pathogen. Conclusion: Teen-SPARC may be able to assist health departments aiming to tailor behavioral interventions for STI prevention among adolescents.