Several trends in sexually transmitted diseases (STDs) have laid the
foundation for a new paradigm for STD treatment and prevention that encompasses
a community-wide, population-oriented approach. Public health STD programs,
in partnership with a wide variety of community collaborators, will need to
carry out the essential functions of public health—assessment, policy
development, and assurance—by developing resources for community organizing
and planning, enhanced information systems, and comprehensive training programs
for professional staff and community partners. Community providers (particularly
practicing clinicians and community and hospital clinics) will need to deliver
primary prevention (community health promotion and clinical preventive services)
and secondary prevention (screening and treatment) services while categorical
STD clinics focus on providing care for high-risk, high-frequency STD transmitters
who serve as the reservoir for much of a community's bacterial STDs. Managed
care organizations and public health STD programs will need to formalize collaborative
arrangements and capitalize on the strengths of each organization in order
to have a population-level impact on STD transmission.
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