Prevention of the sexually transmitted diseases∗

Abstract

Control of venereal diseases in some countries depends solely on the treatment of symptomatic cases. Other countries also engage in the tracing and testing of the sexual contacts of those cases, and a few also screen various population groups for inapparent infections. The difficulty is that, even when all three methods of control are used, each 100 cases on the average give rise to slightly more than 100 fresh infections before diagnosis and treatment. One way to interrupt this series of infections, and to curb the sexually transmitted diseases, is through prophylaxis-here defined as measures taken before, during, or shortly after exposure to reduce the likelihood of disease transmission or to abort an incipient infection. Unlike the other forms of control, VD prophylaxis is effective before there is any opportunity for further transmission-and thus has a greater effect on curbing future incidence. Reviewed here are eleven methods of prophylaxis-all designed to reduce the likelihood that an infection will be passed along when a man has sexual relations with an infected woman or when a woman has sexual relations with an infected man. Several of these methods are usable for oral-genital and anal-genital as well as genital-genital contacts. Many of the methods are effective against monilial, trichomonal, and other infections as well as against syphilis and gonorrhea. Like other medical procedures, none of these is 100-percent effective. Prophylaxis should therefore be considered along with, not in place of, case-finding and treatment procedures described. Each method of prophylaxis, however, can contribute its mite to individual protection and thus to a downturn in the incidence and prevalence of VD.