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The Hidden Epidemic: Confronting Sexually Transmitted Diseases (1997)
Institute of Medicine (IOM)

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. "ESTABLISHING AN EFFECTIVE NATIONAL SYSTEM TO PREVENT STDs." The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press, 1997.

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  1. improve public and health professional awareness and knowledge of STDs and promote healthy behaviors on a national basis;
  2. ensure that health professionals are appropriately and adequately trained to provide STD-related services, including clinical services, disease prevention activities, and community-based prevention programs;
  3. ensure that STD prevention activities are an integral part of national HIV and cancer prevention programs;
  4. support and conduct research to improve strategies for STD prevention;
  5. coordinate STD prevention programs, including research activities, among states and relevant federal agencies, including the CDC, the National Institutes of Health, the Health Resources and Services Administration, the Health Care Financing Administration, the Substance Abuse and Mental Health Services Administration, the Agency for Health Care Policy and Research, the Food and Drug Administration, and the Indian Health Service; and
  6. expand and maximize existing funding streams and develop new and increased resources from both public and private sources to support this system at all levels.
Promoting State Leadership

Within state and local governments, the health department is responsible for implementing STD-related programs and is the logical agency to lead STD prevention efforts. Other agencies and state and local elected officials, however, need to support the efforts of these health departments, because the health department may not have sufficient authority or resources to implement interventions. In cases where direct responsibility for some aspects of STD-related clinical care is under the purview of another agency, the health department needs to assume a coordinating role.

State and local health departments vary considerably in their capacity and technical ability to provide clinical and outreach services and to conduct disease surveillance, quality assurance, and training activities. Most state and local health agencies, however, will require substantial additional funding and technical assistance to fully establish an effective system of STD prevention in their jurisdiction.

Therefore, the committee makes the following recommendation:

  • State government efforts in STD prevention, through the leadership of the state health department and with support and technical assistance from the CDC, should:
  1. develop, implement, and support a comprehensive STD prevention system throughout the state;
  2. provide guidance and financial and technical assistance to local health
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