Landry D J, Forrest J D
Alan Guttmacher Institute (AGI), New York, USA.
Fam Plann Perspect. 1996 Nov-Dec;28(6):261-6.
Results of a 1995 survey reveal that 1,437 local health departments-half 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% of the poverty level (83%), women (60%) and non-Hispanic whites or blacks (55% and 35%, respectively); 36% of clients are younger than 20, and 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 services only in sessions dedicated to STD care, 37% always integrate STD and other services, such as family planning, in the same clinic sessions, and 49% offer both separate and integrated sessions. STD programs that integrate services with other health care typically cover nonmetropolitan areas, have small caseloads, serve mainly women and provide a variety of contraceptives. In contrast, those that offer services only in dedicated sessions generally are in metropolitan areas and have large caseloads; most of their clients are men, and few provide contraceptive methods other than the male condom.
1995年的一项调查结果显示，1437个地方卫生部门（占全国卫生部门总数的一半）提供性传播疾病（STD）服务，每年接待约200万患者。其患者主要是收入低于贫困线250%的个人（83%）、女性（60%）以及非西班牙裔白人或黑人（分别占55%和35%）；36%的患者年龄在20岁以下，30%的患者年龄在20至24岁之间。平均而言，接受性传播疾病检测的患者中，23%患有衣原体感染，13%患有淋病，3%患有早期梅毒，18%患有其他性传播疾病，43%没有性传播疾病。几乎所有的公共性传播疾病项目都提供淋病和梅毒的检测与治疗；只有82%的项目检测衣原体，但97%的项目提供衣原体治疗。约14%的项目仅在专门的性传播疾病护理时段提供服务，37%的项目总是在同一诊所时段将性传播疾病服务与其他服务（如计划生育）整合在一起，49%的项目既提供单独的时段服务，也提供整合的时段服务。将服务与其他医疗保健整合的性传播疾病项目通常覆盖非都市地区，病例量小，主要服务女性，并提供多种避孕措施。相比之下，那些仅在专门时段提供服务的项目通常位于都市地区，病例量大；其大多数患者为男性，除男用避孕套外，很少提供其他避孕方法。
