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CONTEXT: Each year, millions of U.S. youth acquire sexually transmitted diseases (STDs). Estimates of the economic burden of STDs can help to quantify the impact of STDs on the nation's youth and on the payers of the cost of their medical care.

METHODS: We synthesized the existing literature on STD costs to estimate the lifetime medical cost per case of eight major STDs–HIV, human papillomavirus (HPV), genital herpes simplex virus type 2, hepatitis B, chlamydia, gonorrhea, trichomoniasis and syphilis. We then estimated the total burden of disease by multiplying these cost-per-case estimates by the approximate number of new cases of STDs acquired by youth aged 15–24.

RESULTS: The total estimated burden of the nine million new cases of these STDs that occurred among 15–24-yearolds in 2000 was $6.5 billion (in year 2000 dollars). Viral STDs accounted for 94% of the total burden ($6.2 billion), and nonviral STDs accounted for 6% of the total burden ($0.4 billion). HIV and HPV were by far the most costly STDs in terms of total estimated direct medical costs, accounting for 90% of the total burden ($5.9 billion).

CONCLUSIONS: The large number of infections acquired by persons aged 15–24 and the high cost per case of viral STDs, particularly HIV, create a substantial economic burden.