[Secondary prevention of sexually transmissible diseases in public health service--analysis of initial experiences in a Bremen counselling office of the chief public health office].

Medical activities of the Public Health STD programme in Bremen were analysed during a period of one year. This experimental project comprises various activities on primary prevention, counselling services, including streetwork, on social and health issues related to sexual health and confidential, anonymous diagnosis and treatment of STD. 621 examination in 248 patients were evaluated. The need for STD screening and treatment has not yet been assessed in Bremen. Nevertheless, a considerable number of individuals considered themselves in need for STD screening or treatment in a public health setting. In comparison with 1975-1985, when bimonthly mandatory screening on female prostitutes was common in Bremen, the number of examinations declined by a factor of ten, whereas the actual number of treated persons remained stable. Of all examinations, 511 (82.3%) were carried out on females, 110 (17.7%) on males, 351 (56.5%) on German citizens and 270 (43.5%) on clients with foreign citizenship. 461 (74.2%) of all examinations involved female prostitutes. Sexually transmitted diseases were shown to be present in 39.3% (244/621) of the examinations. In addition, "vaginitis" was found in 47.7% of gynaecological checks. The STD prevalence was extraordinary high in female drug-addicted (75%) and foreign prostitutes (40.6%). Only in foreign prostitutes a significant association between incidence of STD and age was found. Costs in relation to the detection of one STD were found to be rather low compared to the benefit to the individuals and the society. Therefore, the STD/HIV prevention programme should be maintained.