This vision and the committee's proposed model for improving STD prevention are founded on a multifaceted approach to prevention, shared responsibility and active participation by individuals and the community, coordination of related programs, and adequate resources and support for implementation.

To realize this vision, the committee recommends that:

  • An effective national system for STD prevention be established in the United States.

The committee envisions a system based on national policy, coordinated at all levels, and composed of local, state, and national prevention programs. A national system is essential because STDs are a threat to the nation's health, because many interventions are most effectively or efficiently developed and implemented at the national level, and because STDs do not recognize geographic borders.

To establish a national system for STD prevention, the committee recommends four major strategies for public and private sector policymakers at the local, state, and national levels:

  1. Overcome barriers to adoption of healthy sexual behaviors.
  2. Develop strong leadership, strengthen investment, and improve information systems for STD prevention.
  3. Design and implement essential STD-related services in innovative ways for adolescents and underserved populations.
  4. Ensure access to and quality of essential clinical services for STDs.

Before describing the recommended tactics for these four strategies, the committee makes the following recommendations regarding two important concepts that need to be incorporated into a national strategy to prevent STDs: the impact of STDs on HIV transmission and the impact of STDs on cancer.

  • Improved prevention of STDs should be an essential component of a national strategy for preventing sexually transmitted HIV infection.
  • Government agencies and private organizations concerned with cancer prevention should support STD prevention activities as an important strategy for prevention of STD-related cancers.

Strategy 1: Overcome barriers to adoption of healthy sexual behaviors.

Barriers to effective STD prevention efforts include biological, social, and



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