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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for this report were chosen for their special competencies and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

Funding for this project was provided by Centers for Disease Control and Prevention, Glaxo Wellcome, Inc., The Henry J. Kaiser Family Foundation, National Institute of Allergy and Infectious Diseases, NIH Office of Research on Women's Health, Ortho-McNeil Pharmaceutical, and SmithKline Beecham Pharmaceuticals. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organization or agencies that provide support for the project.

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Library of Congress Cataloging-in-Publication Data

Institute of Medicine (U.S.). Committee on Prevention and Control of Sexually Transmitted Diseases.

The hidden epidemic: confronting sexually transmitted diseases / Thomas R. Eng and William T. Butler, editors; Committee on Prevention and Control of Sexually Transmitted Diseases, Institute of Medicine, Division of Health Promotion and Disease Prevention.

p. cm.

Includes bibliographical references and index.

ISBN 0-309-05495-8

1. Sexually transmitted diseases—United States. I. Eng, Thomas R. II. Butler, William T. III. Title.

[DMLM: 1. Sexually Transmitted Diseases—prevention & control—United States. 2. Sexually Transmitted Diseases—epidemiology—United States. 3. Health Policy—United States WC 144 159 1997]

RA644.V4I495 1997

614.5'47'0973—dc21

DNLM/DLC for Library of Congress

First Printing, April 1997

Second Printing, July 1998

97-4218

CIP

Copyright 1997 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America.

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The image adopted as a logotype by the Institute of Medicine is based on a relief carving from ancient Greece, now held by the Staalichemuseen in Berlin.



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