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Hidden epidemic: Sexually Transmitted Diseases A recent Institute of Medicine (IOM) report on the high rate of sexually transmitted diseases (STDs) in the United States supports new recommendations for a public education and awareness campaign against these diseases. Sexually transmitted diseases (STDs) are causing a hidden epidemic because many STDs are asymptormatic (have no symptoms) and are difficult to diagnose. The report reveals that most of the 12 million Americans infected with an STD are not aware of it and that most STD prevention efforts are inadequate and have been poorly funded. The panel reported that for every $1 in government spending on STDs, $43 is spent on treatment, suggesting that more funds spent on prevention can be cost effective. Moreover, new prevention efforts targeted at teenagers and women are needed, the report said, including open discussions with doctors. A Kaiser Family Foundahon survey found that over 10 percent of American adults cannot name one STD, one in five think all STDs are incurable, and more than half are unaware that having an STD increases the risk of contracting HIV. The IOM report also said that many heterosexually transmitted HIV infections could be prevented by reducing other STDs. To combat the spread of STD, health officials are calling for more behavioral and community-based interventions, said Dr. Helene Gayle, director of the COC's National Center for HIV, STD, and TB. The agency is strengthening its partnerships at all levels of the public sector and developing greater collaboration with academia, community-based organizations. and other members of the private sector. Use of effective contraceptives plays a key role in disease prevention. Al though correct and consistent use of latex condoms is the most effective method - excluding abstinence - condom use requires male cooperation and consent, which can be difficult to obtain. There is, therefore. a great need for female-controlled prevention methods, particularly those that offer protection against both unwanted pregnancy and STDs. (CDC National AIDS Clearinghouse 12/30/96 and 2/12/97)