Prevention of sexually transmitted diseases from office to globe

Abstract

My interest in prevention of sexually transmitted diseases (STDs) was borne out of my own frustration in managing the maladies of my dermatologic patients over the last 25 years. As they suffered the consequences of what they had understood would be safe sex, via condom use, I began to contemplate that strategy. Safe sex originated in the early 1980s as the buzz-word for promotion of condom use to high-risk population groups to prevent sexual transmission of HIV/AIDS. Since condoms doubled as barrier contraceptive devices, it was not long before safe sex became the prevention strategy of the era. With the use of a simple prophylactic device, the condom, adults and teens alike could, in theory, prevent both HIV transmission and pregnancy. They could be safe in their sexual practices. In the 1980s and 1990s, it became customary for physicians to caution patients to practice safe sex. Then, during the late 1990s, as rising rates of chronic, viral, skin-to-skin transmitted STDs became an increasingly widespread public health problem, the medical literature quietly transitioned to the more accurate description, safer sex. Yet safe sex, long written into classroom curricula and medical pamphlets, was in its second-generation as the prevention strategy for the general public. It was not until one of those people got a sexually transmitted disease (STD) and ended up as a patient that the idea that sex was not really safe had become a reality for that patient and doctor. I began to feel the havoc wreaked in the lives of my patients by diseases that could have been prevented by different choices. Ultimately, I came full circle in my own thinking, from my early venereal-disease-clinic years of see 'em and treat 'em, to becoming an advocate for primary prevention via behavior change. © 2010 Springer-Verlag London.