Gunn R A, Rolfs R T, Greenspan J R, Seidman R L, Wasserheit J N
Division of STD Prevention, National Center for HIV, STD, TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
JAMA. 1998 Mar 4;279(9):680-4. doi: 10.1001/jama.279.9.680.
Several trends in sexually transmitted diseases (STDs) have laid the foundation for a new paradigm for STD treatment and prevention that encompasses a community-wide, population-oriented approach. Public health STD programs, in partnership with a wide variety of community collaborators, will need to carry out the essential functions of public health-assessment, policy development, and assurance-by developing resources for community organizing and planning, enhanced information systems, and comprehensive training programs for professional staff and community partners. Community providers (particularly practicing clinicians and community and hospital clinics) will need to deliver primary prevention (community health promotion and clinical preventive services) and secondary prevention (screening and treatment) services while categorical STD clinics focus on providing care for high-risk, high-frequency STD transmitters who serve as the reservoir for much of a community's bacterial STDs. Managed care organizations and public health STD programs will need to formalize collaborative arrangements and capitalize on the strengths of each organization in order to have a population-level impact on STD transmission.
性传播疾病（STD）的几种趋势为性传播疾病治疗和预防的新范式奠定了基础，这种新范式涵盖了全社区、以人群为导向的方法。公共卫生性传播疾病项目与广泛的社区合作伙伴合作，将需要通过开发社区组织和规划资源、增强信息系统以及为专业人员和社区合作伙伴提供全面培训项目来履行公共卫生评估、政策制定和保障的基本职能。社区提供者（特别是执业临床医生以及社区和医院诊所）将需要提供一级预防（社区健康促进和临床预防服务）和二级预防（筛查和治疗）服务，而分类性传播疾病诊所则专注于为高风险、高频性传播疾病传播者提供护理，这些传播者是社区许多细菌性性传播疾病的传染源。管理式医疗组织和公共卫生性传播疾病项目将需要规范合作安排，并利用每个组织的优势，以便对性传播疾病传播产生人群层面的影响。
