The Public Health Service Action Plan for Women's Health: STDs To the Editor.\p=m-\Asexecutive director of the only national, voluntary, nonprofit agency dedicated solely to the prevention of all sexually transmitted diseases (STDs), I protest the absence of any mention of STDs in Dr Mason's proposed national agenda for women's health.1 Each year, millions of women acquire STDs that can cause real damage to their bodies and their ability to bear children, as well as to the children they may be carrying\p=m-\alltaxing a sorely pressed health care system and costing Americans billions of precious health care dollars. Some further research is needed in some areas, but many of the tools we need to fight these diseases are at hand, and only the lack of public funds prevents proven programs from being implemented. We know, for instance, how to diagnose and treat chlamydia. Yet, a chlamydia control program first proposed 10 years ago has yet to be implemented, despite the fact that we are spending more on the disease's long-term consequences than we would to actually implement the con¬ trol program. Sexually transmitted diseases present a serious threat to women's health. To ignore them while discussing a national health agenda aimed at helping women is short-sighted at best and victim-blaming at its worst. If the Public Health Service (PHS) truly wants to help women, it will focus on all the health problems they face, not just the ones that may suit a
current
timated 4 million chlamydial infections lead to at least 250 000 cases of pelvic inflammatory disease and subsequent infer¬ tility and ectopie pregnancies. More than 75 000 babies will develop chlamydial conjunctivitis or pneumonia. A chlamydia control program was first proposed in 1985 and it has yet to be implemented. It would cost far less to initiate such a program than the treatment of these infections and their complications currently cost us. Sexually transmitted disease control efforts will also reduce the transmission of the human immunodeficiency virus. But the STDs alone are major prob¬ lems. Gonorrhea is still a major disease. Herpes simplex virus and human papillomavirus infections are epidemic. Syphilis and chancroid continue to increase. It is simply unacceptable for our society to suffer the toll that STDs exact, and it is clear that women and infants bear the major burden of these STDs. We hope that STDs can someday appear on the national agenda for women's health. Julius Schachter, PhD San Francisco STD Cooperative Research Center Joel B. Baseman, PhD San Antonio STD Cooperative Research Center King K. Holmes, MD, PhD Seattle STD Cooperative Research Center Robert B. Jones, MD, PhD Mid-West STD Cooperative Research Center Indianapolis, Ind 1. Mason JO. A national
political agenda.
1992;267:482.
Reply.\p=m-\Asa goal-driven, comprehensive blueprint for improving the health of all women, the PHS Action Plan for Women's Health addresses a wide range of age-specific issues
American Social Health Association Research Triangle Park, NC
agenda
for women's health. JAMA.
In
Peggy Clarke
1. Mason JO. A national
agenda
for women's health. JAMA.
1992;267:482.
To the Editor.\p=m-\Ina recent issue of JAMA, Mason summarized a national agenda for women's health.1 Certainly there were many important problems listed in that agenda and we applaud every effort at improving the health of America's women. However, we wish to address a serious omission from the national agenda, that STD represents a major women's health problem in this country. Sexually transmitted diseases are epidemic. Each year, 10 to 20 million women will acquire a sexually transmitted infection in this country. These infections cost billions of dollars in health care, but the toll in human suffering is immeasurable. Because of STDs, hundreds of thousands of women will be rendered involuntarily sterile, tens of thousands will have ectopic pregnancies or develop cancerous or precancerous lesions of the genital tract. Many women will suffer complications of pregnancy and their infants may develop perinatal infections with serious consequences. It is clear that we need more research to address and resolve these problems. How¬ ever, tools have been available to reduce STD-related disease and complications in women, but funds have not been com¬ mitted to address the problems. For example, methods of diagnosing and treating chlamydial infections are currently available. Yet, each year an esEdited by Drummond Rennie, MD, Deputy Editor (West), and Bruce B. Dan, MD, Senior Editor.
and conditions, including STDs. Although the one-page space limitation in the JAMA article did not permit discussion of every women's health issue, the Action Plan identifies educational, preventive, and research initiatives for lowering the STD rate among women. For example, the Centers for Disease Control (CDC) is addressing STD morbidity, including the complications of pelvic inflammatory disease, ectopic pregnancy, infertility, cervical cancer, and immune deficiencies. A number of prevention projects, including screening programs, have been implemented through grants to state and local health departments for chlamydia, gonorrhea, and syphilis control. The CDC has developed STD prevention messages for incorporation into behavior-based school curricula. And STD prevention messages are being implemented in a variety of
Guidelines for Letters Letters will be published at the discretion of the editors as space permits and are subject to editing and abridgment. They should be typewritten double-spaced and submitted in duplicate. They should
if any, should be held to fewer. Letters discussing a recent JAMA article should be received within 1 month of the article's pub¬ lication. Letters must not duplicate other material published or sub¬ mitted for publication. A signed statement for copyright, authorship responsibility, and financial disclosure is essential for publication. Letters not meeting these guidelines are generally not acknowl¬ edged. We do not routinely return unpublished letters. Also see In¬ structions for Authors.
not exceed 500 words of text. a
minimum, preferably five
References,
or
Downloaded From: http://jama.jamanetwork.com/ by a Penn State Milton S Hershey Med Ctr User on 05/26/2015
current
timated 4 million chlamydial infections lead to at least 250 000 cases of pelvic inflammatory disease and subsequent infer¬ tility and ectopie pregnancies. More than 75 000 babies will develop chlamydial conjunctivitis or pneumonia. A chlamydia control program was first proposed in 1985 and it has yet to be implemented. It would cost far less to initiate such a program than the treatment of these infections and their complications currently cost us. Sexually transmitted disease control efforts will also reduce the transmission of the human immunodeficiency virus. But the STDs alone are major prob¬ lems. Gonorrhea is still a major disease. Herpes simplex virus and human papillomavirus infections are epidemic. Syphilis and chancroid continue to increase. It is simply unacceptable for our society to suffer the toll that STDs exact, and it is clear that women and infants bear the major burden of these STDs. We hope that STDs can someday appear on the national agenda for women's health. Julius Schachter, PhD San Francisco STD Cooperative Research Center Joel B. Baseman, PhD San Antonio STD Cooperative Research Center King K. Holmes, MD, PhD Seattle STD Cooperative Research Center Robert B. Jones, MD, PhD Mid-West STD Cooperative Research Center Indianapolis, Ind 1. Mason JO. A national
political agenda.
1992;267:482.
Reply.\p=m-\Asa goal-driven, comprehensive blueprint for improving the health of all women, the PHS Action Plan for Women's Health addresses a wide range of age-specific issues
American Social Health Association Research Triangle Park, NC
agenda
for women's health. JAMA.
In
Peggy Clarke
1. Mason JO. A national
agenda
for women's health. JAMA.
1992;267:482.
To the Editor.\p=m-\Ina recent issue of JAMA, Mason summarized a national agenda for women's health.1 Certainly there were many important problems listed in that agenda and we applaud every effort at improving the health of America's women. However, we wish to address a serious omission from the national agenda, that STD represents a major women's health problem in this country. Sexually transmitted diseases are epidemic. Each year, 10 to 20 million women will acquire a sexually transmitted infection in this country. These infections cost billions of dollars in health care, but the toll in human suffering is immeasurable. Because of STDs, hundreds of thousands of women will be rendered involuntarily sterile, tens of thousands will have ectopic pregnancies or develop cancerous or precancerous lesions of the genital tract. Many women will suffer complications of pregnancy and their infants may develop perinatal infections with serious consequences. It is clear that we need more research to address and resolve these problems. How¬ ever, tools have been available to reduce STD-related disease and complications in women, but funds have not been com¬ mitted to address the problems. For example, methods of diagnosing and treating chlamydial infections are currently available. Yet, each year an esEdited by Drummond Rennie, MD, Deputy Editor (West), and Bruce B. Dan, MD, Senior Editor.
and conditions, including STDs. Although the one-page space limitation in the JAMA article did not permit discussion of every women's health issue, the Action Plan identifies educational, preventive, and research initiatives for lowering the STD rate among women. For example, the Centers for Disease Control (CDC) is addressing STD morbidity, including the complications of pelvic inflammatory disease, ectopic pregnancy, infertility, cervical cancer, and immune deficiencies. A number of prevention projects, including screening programs, have been implemented through grants to state and local health departments for chlamydia, gonorrhea, and syphilis control. The CDC has developed STD prevention messages for incorporation into behavior-based school curricula. And STD prevention messages are being implemented in a variety of
Guidelines for Letters Letters will be published at the discretion of the editors as space permits and are subject to editing and abridgment. They should be typewritten double-spaced and submitted in duplicate. They should
if any, should be held to fewer. Letters discussing a recent JAMA article should be received within 1 month of the article's pub¬ lication. Letters must not duplicate other material published or sub¬ mitted for publication. A signed statement for copyright, authorship responsibility, and financial disclosure is essential for publication. Letters not meeting these guidelines are generally not acknowl¬ edged. We do not routinely return unpublished letters. Also see In¬ structions for Authors.
not exceed 500 words of text. a
minimum, preferably five
References,
or
Downloaded From: http://jama.jamanetwork.com/ by a Penn State Milton S Hershey Med Ctr User on 05/26/2015
