USING STD OCCURRENCE TO MONITOR AIDS-PREVENTION (REPRINTED FROM SOCIAL-SCIENCE MEDICINE, VOL 38, PG 1153-65, 1994)

Monitoring the effects of AIDS prevention programmes is increasingly i mportant but methodologically difficult. The use of surveillance deriv ed measures of the occurrence of sexually transmitted diseases as indi cators of high risk sexual behaviour, or of HIV incidence, has been wi dely recognised as a possible approach. This paper first examines the theoretical and empirical basis for this strategy, and highlights, usi ng examples, some of the pitfalls in the interpretation of trends in s exually transmitted disease occurrence. Problems arising in the interp retation of the types of STD surveillance data currently available in countries in Western Europe are discussed. Ways in which STD surveilla nce systems might be developed so as to enhance their value in monitor ing AIDS prevention are proposed The paper goes on to identify areas o f clinical and epidemiological research which might improve our abilit y to interpret such enhanced STD surveillance data.