LAUSR

BACKGROUND STD partner services (PS) are a core component of STD programs. Data on costs are needed to support PS programming. METHODS In Washington State STD PS programs, disease intervention specialists (DIS) conduct telephone-based interviews and occasional field visits, offer expedited partner therapy (EPT) to heterosexuals with gonorrhea or chlamydia, and promote HIV testing, pre-exposure prophylaxis (PrEP), and HIV care. We conducted activity-based micro-costing of PS, including: observational and self-reported time studies and interviews. We analyzed cost, surveillance, and service delivery data to determine costs per program outcomes. RESULTS In King, Pierce, and Spokane counties, respectively, DIS allocated 6.5, 6.4, and 28.8 hours per syphilis case and 1.5, 1.6, and 2.9 hours per gonorrhea/chlamydia case, on average. In 2016, each full-time DIS investigated 270, 268, and 61 syphilis and 1,177, 1,105, and 769 gonorrhea/chlamydia cases. >80% of syphilis cases in King and Pierce were among men who have sex with men vs. 38% in Spokane. DIS spent 12%-39% of their time actively interviewing cases and notifying partners (clients), and the remaining time locating clients, coordinating and verifying care, and managing case reports. Time spent on EPT, HIV testing, and referrals to HIV treatment or PrEP, was minimal (<5 minutes per interview) at locations with resources outside PS staff. Program cost-per-interview ranged from $527-$2,210 for syphilis, $219-$484 for gonorrhea, and $164-$547 for chlamydia. DISCUSSION STD PS resource needs depended on epidemic characteristics and program models. Integrating HIV prevention objectives minimally impacted PS-specific program costs. Results can inform program planning, future budget impact, and cost-effectiveness analyses.