Harrell W. Chesson, PhD, Division of STD Prevention, Centers for Disease Control, 1600 Clifton Road, MS E44, Atlanta, GA 30333, 404-639-8182, hbc7@cdc.gov, Paul Harrison, PhD, Federal Reserve Board, Washington, DC, 20th Street and Constitution Avenue, NW, Washington, DC 20551, Carol R. Scotton, PhD, Division of HIV/AIDS Prevention, CDC, 1600 Clifton Road, Atlanta, GA 30333, and Beena Varghese, PhD, Centre for Health and Population Research, Dhaka, Bangladesh, na, Dhaka, Bangladesh.

Objective: The Centers for Disease Control and Prevention (CDC) is the primary federal source for HIV and STD prevention funding in the USA. We examined the association between state-level STD incidence rates and funding for HIV and STD prevention provided to the 50 states by CDC.

Methods: We examined the association between state-level gonorrhea incidence rates and CDC grants to states for HIV and STD prevention over the period 1981-1998 using a fixed effects regression model. The two key variables in our model were the number of new cases of gonorrhea per 100,000 population (the dependent variable) and CDC funding dollars per capita for HIV and STD prevention (an independent variable). We also included variables to control for prevailing differences across states in STD incidence, national STD incidence trends common to all states, within-state trends in STD incidence, and additional demographic factors associated with STD incidence rates.

Results: Greater amounts of prevention funding in a given year are associated with reductions in reported gonorrhea incidence rates in subsequent years.

Conclusions: Although many studies have suggested that HIV and STD prevention activities are a sound public health investment, our analysis is the first to provide evidence of a temporal link between higher fiscal investment in prevention and reductions in STD incidence rates.

Learning Objectives: