critical for monitoring population trends in health behaviors, developing effective interventions, and evaluating program effectiveness. Such research, however, has been severely criticized by some policymakers and interest groups. This committee, while recognizing the sincere concerns expressed, strongly believes that research regarding STD-related health behaviors, especially among adolescents, is critical to STD prevention. Federal funding and support for sexual health behavior research is essential. The committee found no evidence that asking questions regarding sexual activity increases sexual activity among survey respondents. Restrictions on collecting behavioral information from adolescents would seriously jeopardize behavioral research and the ability to prevent high-risk behaviors among adolescents. The committee also believes that the objectivity and integrity of the peer-review process for scientific research should be protected.
With respect to the above issues, the committee makes the following recommendation:
To build an effective national system, highly visible and strong leadership and support are needed from both the public and private sectors, and especially from elected officials. Among public agencies, the Department of Health and Human Services, especially the Centers for Disease Control and Prevention (CDC), and state and local health departments have critical leadership roles. The public sector must continue to play a major role in preventing STDs, but does not have the resources or the organizational reach to fully implement a national system of STD-related services. The private sector must therefore take more responsibility.
The barriers to an effective national system for STD prevention are found in government, private sector organizations, and political factors and social norms. Overcoming these barriers is a challenge that requires the active participation of all levels of government, the private health care sector, businesses, labor leaders, the mass media, schools, and many community-based organizations. In developing and implementing a national system for STD prevention, it is important that stakeholders be involved in all steps of the process; however, a formal mechanism for collaboration among agencies and organizations does not exist. Therefore,