Exploring the costs and outcomes of sexually transmitted infection (STI) screening interventions targeting men in football club settings: preliminary cost-consequence analysis of theSPORTSMARTpilot randomised controlled trial

Abstract

BackgroundThe objective of this study was to compare the costs and outcomes of two sexually transmitted infection (STI) screening interventions targeted at men in football club settings in England, including screening promoted by team captains.MethodsA comparison of costs and outcomes was undertaken alongside a pilot cluster randomised control trial involving three trial arms: (1) captain-led and poster STI screening promotion; (2) sexual health advisor-led and poster STI screening promotion and (3) poster-only STI screening promotion (control/comparator). For all study arms, resource use and cost data were collected prospectively.ResultsThere was considerable variation in uptake rates between clubs, but results were broadly comparable across study arms with 50% of men accepting the screening offer in the captain-led arm, 67% in the sexual health advisor-led arm and 61% in the poster-only control arm. The overall costs associated with the intervention arms were similar. The average cost per player tested was comparable, with the average cost per player tested for the captain-led promotion estimated to be £88.99 compared with £88.33 for the sexual health advisor-led promotion and £81.87 for the poster-only (control) arm.ConclusionsCosts and outcomes were similar across intervention arms. The target sample size was not achieved, and we found a greater than anticipated variability between clubs in the acceptability of screening, which limited our ability to estimate acceptability for intervention arms. Further evidence is needed about the public health benefits associated with screening interventions in non-clinical settings so that their cost-effectiveness can be fully evaluated.

Assessing the costs and outcomes of control programmes for sexually transmitted infections: a systematic review of economic evaluations

“…Table 1 provides an overview of the main characteristics of the 31 studies identified for inclusion. The main countries where the studies took place were the Netherlands (7) [21][22][23][24][25][26][27], UK (8) [28][29][30][31][32][33][34][35], and United States of America (12). The majority of studies compared the costeffectiveness or cost-utility of two or more different screening options for chlamydia (25 studies).…”

“…The majority of studies compared the costeffectiveness or cost-utility of two or more different screening options for chlamydia (25 studies). Six studies included gonorrhoea screening in their strategy [28,[36][37][38] and one focussed on the cost-effectiveness of age-specific HIV screening. [39] The search did not identify any study assessing interventions for syphilis.…”

“…was the only study that exclusively focused on the cost-effectiveness of screening men for STIs. [28]…”

“…[31,[44][45][46] The cost-consequence analysis by Jackson et al found that costs and outcomes were similar across the assessed interventions. [28]…”

Near patient chlamydia and gonorrhoea screening and treatment in further education/technical colleges: a cost analysis of the ‘Test n Treat’ feasibility trial

“…A more recent study of routine repeat screening in the Netherlands reported screening costs of £100 per-screen (inflated and converted from 2014 data) [22]. A community CT screening study in England aimed at men attending sports clubs estimated that costs ranged from £92 to £100 per screen (inflated from 2013 estimates) with no CT infections detected [23].…”