The fact that many STDs resist treatment and will continue to affect their hosts for life is only one reason why prevention of STDs is the best way to control them. The costs attributed to STDs in the U.S. and abroad are high, both in terms of resources as well as human pain and suffering.
STD prevention is dependent on lowering the basic reproductive number, (R ), the number of contacts per unit time x transmission probability per contact x duration of infectiousness. Each factor in the equation must be dealt with separately.
The first strategy refers to the reduction of the average rate of partner change in all population groups. Reduction could be achieved through advocacy of safer sex practices (use of condoms during vaginal or anal intercourse, and condoms or plastic barriers during oral sex), not just through advocacy of abstinence. Barriers to this strategy in the U.S. include resistance to sex education program implementation, particularly for the most vulnerable segment of the population: adolescents.
The second strategy refers to the reduction of the transmission probability per contact. This could be achieved also through advocacy of safer sex practices. In addition, minimizing the duration of infectiousness (the third strategy) can reduce the transmission probability. Prompt treatment of STDs is another way to make this strategy successful, since having an STD with an open lesion or irritated genital tract predisposes one to acquiring other STDs.
Minimizing the duration of infectiousness also depends on prompt and adequate treatment of STDs. Since many STDs are asymptomatic, reducing the duration of infectiousness will also depend on a health care provider screening for STDs in susceptible populations. For example, all sexually active women should be screened for chlamydia when they obtain a yearly physical exam, and pregnant women should be (and usually are) screened for STDs during the course of their prenatal care. Yet altogether too often health care providers focus on the diagnosis of diseases in symptomatic patients, and fail to consider screening, and spend little time on health education and risk reduction counseling.
Health care providers and health educators are not the only people who can advocate for the prevention of STDs. Individuals can educate their family and friends. Learn about STDs and safer sex, and teach others. Learn how to properly use a condom. Many resources are available on the Internet. Reliable information about STDs and their prevention can be obtained from the Centers for Disease Control and Prevention website, located at http://www.cdc.gov/nchstdp/.
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