PUBLIC-HEALTH DEPARTMENTS PROVIDING SEXUALLY-TRANSMITTED DISEASE SERVICES

Results of a 1995 survey reveal that 1,437 local health departments-ha lf of those in the country-provide sexually transmitted disease (STD) services and receive about two million client visits each year. Their clients are predominantly individuals with incomes of less than 250% o f the poverty level (83%), women (60%) and non-Hispanic whites or blac ks (55% and 35%, respectively); 36% of clients are younger than 20, an d 30% are aged 20-24. On average, 23% of clients tested for STDs have chlamydia, 13% have gonorrhea, 3% have early-stage syphilis, 18% have some other STD and 43% have no STD. Virtually all public STD programs offer testing and treatment for gonorrhea and syphilis; only 82% test for chlamydia, but 97% provide treatment for it. Some 14% offer servic es only in sessions dedicated to STD care, 37% always integrate STD an d other services, such as family planning, in the same clinic sessions , and 49% offer both separate and integrated sessions. STD programs th at integrate services with other health care typically cover nonmetrop olitan areas, have small caseloads, serve mainly women and provide a v ariety of contraceptives. In contrast, those that offer services only in dedicated sessions generally are in metropolitan areas and have lar ge caseloads; most of their clients are men, and few provide contracep tive methods other than the male condom.