clinics without acknowledging their health insurance status. In such situations, the local health department ends up paying the cost of the services (Gary Richwald, Los Angeles County STD Program, personal communication, November 1995).
Patients may be referred to public STD clinics by health care providers who either have made a diagnosis requiring treatment or feel that the STD can be better managed by health care providers in public STD clinics. Reasons cited by clinic patients for seeking medical care included genitourinary symptoms (55-70 percent of individuals); notification of recent sexual contact with a partner diagnosed with an STD (15-20 percent); and perceived risk and desire for STD screening (approximately 20 percent) (Celum et al., 1995).
Publicly funded STD-related services are provided both by dedicated public STD clinics and within the context of primary care by community-based programs. Dedicated public STD clinics are located in every state, every major city,