The role of STDs in cervical, liver, and other cancers is not well recognized by health professionals and the public, and information regarding this link needs to be disseminated widely.
Therefore, the committee makes the following recommendation:
The committee's discussion of, and recommended tactics for implementing, its four strategies for establishing a national system for STD prevention are now presented.
Strategy 1 is to overcome barriers to adoption of healthy sexual behaviors. Barriers to effective STD prevention efforts include biological, social, and structural factors. Biological factors reviewed in Chapters 2 and 3 include preexisting or concurrent STDs, the impact of asymptomatic infections, the long lag time to clinical complications, increased susceptibility of women and female adolescents to sexually transmitted pathogens, lack of curative treatment for viral STDs, lack of vaccines against most STDs, and immunological factors. Many of these factors are difficult to alter. In addition, some social factors, such as poverty, inadequate access to health care, substance use, sexual abuse, and violence, are enormously complex issues, with solutions beyond the scope of this committee. However, the committee believes that the major social factor that contributes to the STD epidemic-the reluctance of American society to openly confront issues regarding sexuality and STDs-can eventually be overcome by a concerted long-term national effort. This issue is a major focus of Strategy 1. Tactics for addressing structural factors, such as the organization of clinical services, are described under Strategy 4.
Under Strategy 1, the committee recommends that (a) a new social norm of healthy sexual behavior be established, (b) knowledge and awareness of STDs be increased; (c) the mass media assist in efforts to reduce risky sexual behaviors;