Confronting a Hidden Epidemic: The Institute Of Medicine's Report on Sexually Transmitted Diseases

Abstract

the economic consequences of HIV and AIDS are included in the estimate, total costs associated with STD-related illnesses reached almost $17 billion. A “Hidden Epidemic” The public is largely unaware of the serious health consequences and financial costs associated with the high prevalence of STDs in the United States. To call attention to this “hidden epidemic” and to study ways to address the problem, the Institute of Medicine (IOM) in 1994 convened a 15member expert panel. Its mandate was to “(a) examine the epidemiological dimensions of STDs in the United States and factors that contribute to the epidemic; (b) assess the effectiveness of current public health strategies and programs to prevent and control STDs; and (c) provide direction for future public health programs, policy and research in STD prevention and control” 1 [p.1-1]. The Institute directed the panel to focus its efforts on STDs other than HIV infection. The panel’s report, released in November 1996, concluded that the United States lacks “an effective national system for STD prevention” [p. 6-3]. According to the report, prevention is hampered by a variety of factors, including a reluctance to discuss sexual issues and the resultant lack of awareness about STDs, the media’s irresponsible treatment of sex, the fragmentation of services, inadequate training of health professionals and insufficient resources. According to the IOM, bold leadership from policymakers in both the public and the private sectors and at the local, state and national levels is needed in order to overcome these obstacles. The IOM recommends that strategies to enhance STD prevention efforts focus on promoting healthy sexual behavior, developing strong leadership, encouraging greater financial support for STD prevention, targeting services to adolescents and other hard-to-reach groups and ensuring universal access to high-quality services.