Sexually transmitted diseases

This chapter reviews current strategies in the US for the control of sexually transmitted diseases (STDs) and outlines recommendations for future strategies. At present, STD control strategies are influenced by 4 basic factors: the health care system, the different levels of government, the response of medical schools, and varying media attention. The 3 tiers of government in the US have different responsibilities for STD control, necessitating a partnership at the federal, state, and local levels. In particular, state and local health officials need to cooperate to ensure an integrated STD program. Medical schools are de-emphasizing instruction in venereology, meaning that many physicians enter practice without adequated knowledge of STD diagnosis and treatment. Overall, the STD intervention program in the US is comprised of the following components: health education and promotion, disease detection, appropriate treatment, partner tracing and patient counseling, clinical services, training, and research. There is a need for epidemiologic investigations to continually estimate the population at risk, broaden the surveillance of unreported STD, re-examine program activities for more