THE CHANGING PARADIGM OF SEXUALLY-TRANSMITTED DISEASE-CONTROL IN THE ERA OF MANAGED HEALTH-CARE

Several trends in sexually transmitted diseases (STDs) have laid the f oundation for a new paradigm for STD treatment and prevention that: en compasses a community-wide, population-oriented approach, Public healt h STD programs, in partnership with a wide variety of community collab orators, will need to carry out the essential functions of public heal th-assessment, policy development, and assurance-by developing resourc es for community organizing and planning, enhanced information systems , and comprehensive training programs for professional staff and commu nity partners, Community providers (particularly practicing clinicians and community and hospital clinics) will need to deliver primary prev ention (community health promotion and clinical preventive services) a nd secondary prevention (screening and treatment) services while categ orical STD clinics focus on providing care for high-risk, high-frequen cy STD transmitters who serve as the reservoir for much of a community 's bacterial STDs, Managed care organizations and public health STD pr ograms will need to formalize collaborative arrangements and capitaliz e on the strengths of each organization in order to have a population- level impact on STD transmission.