The United States has the dubious distinction of leading the industrialized world in overall rates of sexually transmitted diseases (STDs), with 12 million new cases annually. About 3 million teenagers contract an STD each year, and many will have long-term health problems as a result. Women and adolescents are particularly vulnerable to these diseases and their health consequences. In addition, STDs increase the risk of HIV transmission. The Hidden Epidemic examines the scope of sexually transmitted infections in the United States and provides a critical assessment of the nation's response to this public health crisis. The book identifies the components of an effective national STD prevention and control strategy and provides direction for an appropriate response to the epidemic. Recommendations for improving public awareness and education, reaching women and adolescents, integrating public health programs, training health care professionals, modifying messages from the mass media, and supporting future research are included. The book documents the epidemiological dimensions and the economic and social costs of STDs, describing them as "a secret epidemic" with tremendous consequences. The committee frankly discusses the confusing and often hypocritical nature of how Americans deal with issues regarding sexualityâ€"the conflicting messages conveyed in the mass media, the reluctance to promote condom use, the controversy over sex education for teenagers, and the issue of personal blame. The Hidden Epidemic identifies key elements of effective, culturally appropriate programs to promote healthy behavior by adolescents and adults. It examines the problem of fragmentation in STD services and provides examples of communities that have formed partnerships between stakeholders to develop integrated approaches. The committee's recommendations provide a practical foundation on which to build an integrated national program to help young people and adults develop habits of healthy sexuality. The Hidden Epidemic was written for both health care professionals and people without a medical background and will be indispensable to anyone concerned about preventing and controlling STDs.

One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

Europe's "Black Death" contributed to the rise of nation states, mercantile economies, and even the Reformation. Will the AIDS epidemic have similar dramatic effects on the social and political landscape of the twenty-first century? This readable volume looks at the impact of AIDS since its emergence and suggests its effects in the next decade, when a million or more Americans will likely die of the disease. The Social Impact of AIDS in the United States addresses some of the most sensitive and controversial issues in the public debate over AIDS. This landmark book explores how AIDS has affected fundamental policies and practices in our major institutions, examining: How America's major religious organizations have dealt with sometimes conflicting values: the imperative of care for the sick versus traditional views of homosexuality and drug use. Hotly debated public health measures, such as HIV antibody testing and screening, tracing of sexual contacts, and quarantine. The potential risk of HIV infection to and from health care workers. How AIDS activists have brought about major change in the way new drugs are brought to the marketplace. The impact of AIDS on community-based organizations, from volunteers caring for individuals to the highly political ACT-UP organization. Coping with HIV infection in prisons. Two case studies shed light on HIV and the family relationship. One reports on some efforts to gain legal recognition for nonmarital relationships, and the other examines foster care programs for newborns with the HIV virus. A case study of New York City details how selected institutions interact to give what may be a picture of AIDS in the future. This clear and comprehensive presentation will be of interest to anyone concerned about AIDS and its impact on the country: health professionals, sociologists, psychologists, advocates for at-risk populations, and interested individuals.

From Victorian anxieties about syphilis to the current hysteria over herpes and AIDS, the history of venereal disease in America forces us to examine social attitudes as well as purely medical concerns. In No Magic Bullet, Allan M. Brandt recounts the various medical, military, and public health responses that have arisen over the years--a broad spectrum that ranges from the incarceration of prostitutes during World War I to the establishment of required premarital blood tests. Brandt demonstrates that Americans' concerns about venereal disease have centered around a set of social and cultural values related to sexuality, gender, ethnicity, and class. At the heart of our efforts to combat these infections, he argues, has been the tendency to view venereal disease as both a punishment for sexual misconduct and an index of social decay. This tension between medical and moral approaches has significantly impeded efforts to develop "magic bullets"--drugs that would rid us of the disease--as well as effective policies for controlling the infections' spread. In this 35th anniversary edition of No Magic Bullet, Brandt reflects on recent scholarship, the persistence of sexually transmitted diseases, and the trajectory of the HIV epidemic, as they have informed contemporary conceptions of biomedicine and global health.

Amid ongoing shifts in the world economic and political order, the promise for future public health is tenuous. Will today's economic systems sustain tomorrow's health? Will future generations inherit fair access to health and health care? An important hope for the health of future generations is the establishment of a well-grounded, global public health system. Global Public Health: Ecological Foundations addresses both the challenges and cooperative solutions of contemporary public health, within a framework of social justice, environmental sustainability, and global cooperation. With an emphasis on ecological foundations, this book approaches public health principles-history, foundations, topics, and applications-with a community-oriented perspective. By achieving global reach through cooperative, community-based interventions, this text illustrates that the practical application of public health principles can help maintain the health of the world's people. Blending established wisdom with new perspectives, Global Public Health will stimulate better understanding of how the different streams of public health can work more synergistically to promote global health equity. It is a foundation for future public health measures to be built and to succeed.

This comprehensive, well-illustrated, and easily accessible book documents the latest research outcomes concerning sexually transmitted infections (STIs) and describes important advances in their prevention, diagnosis and treatment. The changes in the epidemiology and clinical aspects of STIs that have occurred over the past decade are fully explored, with special attention to core groups and patients with immunological disorders. The emerging challenges associated with particular sexually transmitted pathogens, including C. trachomatis, N. gonorrhoeae, HPV, and HIV, are identified and discussed. Readers will find detailed information on modern preventive strategies, new laboratory and diagnostic techniques, and a range of innovative treatments, including vaccines, continuous antiretroviral therapy, and new drugs against hepatitis viruses. Attention is also drawn to new directions in biomedical research that promise clinical benefits for the patients and communities. The combination of a detailed clinical and research approach, with emphasis on new knowledge and innovative aspects, ensures that the book will be of value to a wide readership comprising both clinicians and researchers.