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

Ann Epidemiol. 2020 Jul:47:13-18. doi: 10.1016/j.annepidem.2020.05.009. Epub 2020 May 27.

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.

Keywords: Adolescents; Chlamydia infections (epidemiology); Gonorrhea (epidemiology); HIV-1 (epidemiology); Mathematical model; Sexual behavior; United States.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Chlamydia Infections / epidemiology*
  • Chlamydia Infections / prevention & control
  • Condoms
  • Female
  • Gonorrhea / epidemiology*
  • Gonorrhea / prevention & control
  • HIV Infections / epidemiology*
  • HIV Infections / prevention & control
  • Humans
  • Male
  • Models, Theoretical
  • New York / epidemiology
  • Risk Reduction Behavior*
  • Risk-Taking
  • Safe Sex*
  • Sexual Behavior*
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases / prevention & control
  • United States / epidemiology