The Hidden Epidemic: Confronting Sexually Transmitted Diseases

Excerpt

Of the top ten most frequently reported diseases in 1995 in the United States, five are sexually transmitted diseases (STDs) (CDC, 1996c). With approximately 12 million new cases of STDs occurring annually (CDC, DSTD/HIVP, 1993), rates of curable STDs in the United States are the highest in the developed world. In 1995, STDs accounted for 87 percent of all cases reported among the top ten most frequently reported diseases in the United States (CDC, 1996c). Despite the tremendous health and economic burden of STDs, the scope and impact of the STD epidemic are underappreciated and the STD epidemic is largely hidden from public discourse. Public awareness and knowledge regarding STDs are dangerously low, but there has not been a comprehensive national public education campaign to address this deficiency. The disproportionate impact of STDs on women has not been widely recognized. Adolescents and young adults are at greatest risk of acquiring an STD, but STD prevention efforts for adolescents remain unfocused and controversial in the United States. There are many biological and social factors that hinder effective prevention efforts, but few have been elucidated and addressed on a national basis. In addition, the roles and responsibilities of public versus private health care professionals in STD prevention have not been clarified in light of recent changes in health care delivery and financing.

Given the above observations regarding STDs in the United States, the Institute of Medicine (IOM) convened the 15-member Committee on Prevention and Control of Sexually Transmitted Diseases in 1994 to "(a) examine the epidemiological dimensions of STDs in the United States and factors that contribute to the epidemic; (b) assess the effectiveness of current public health strategies and programs to prevent and control STDs; and (c) provide direction for future public health programs, policy, and research in STD prevention and control." The committee was charged to focus its study on STDs other than HIV infection.