Skip to main content
PMC home page
Genitourinary Medicine logoLink to Genitourinary Medicine
. 1997 Apr;73(2):88–94. doi: 10.1136/sti.73.2.88

Health education and promotion for STD prevention: lessons for the next millennium.

W W Darrow 1
PMCID: PMC1195778  PMID: 9215087

Abstract

OBJECTIVE: To review the evolution of health promotion for STD prevention. MAIN OBSERVATIONS: Information and education programmes were provided at the beginning of the 20th century to warn the public about the dangers of venereal infection and to support the medical model of case identification and case management under the care of qualified physicians. The public health approach offered advice about chemical, chemotherapeutic, and barrier prophylaxis, but avoided the issue of social prophylaxis. With the failure of antimicrobial agents to eradicate syphilis in the 1960s, rapid increases of viral sexually transmitted diseases (STDs) and resistant strains of gonorrhoea in the 1970s, and the discovery of AIDS in the 1980s, alternatives to the traditional public health approach were sought and supported with a modest increase of resources. Three major innovations have been introduced to STD prevention as a result: social marketing, community involvement, and behaviour change programmes based on social and psychological concepts and theoretical models. CONCLUSIONS: Health promotion for STD prevention in the future will be characterised by careful assessments of the social and behavioural determinants of sexual risk taking, development and implementation of targeted interventions designed to reduce risk taking, and evaluation of social and behavioural interventions for improvements in STD prevention.

Full text

PDF
91

Images in this article

89Image
on p.89
90Image
on p.90

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aggleton P., O'Reilly K., Slutkin G., Davies P. Risking everything? Risk behavior, behavior change, and AIDS. Science. 1994 Jul 15;265(5170):341–345. doi: 10.1126/science.8023156. [DOI] [PubMed] [Google Scholar]
  2. Aral S. O., Peterman T. A. Defining behavioral methods to prevent sexually transmitted diseases through intervention research. Infect Dis Clin North Am. 1993 Dec;7(4):861–873. [PubMed] [Google Scholar]
  3. Asamoah-Adu A., Weir S., Pappoe M., Kanlisi N., Neequaye A., Lamptey P. Evaluation of a targeted AIDS prevention intervention to increase condom use among prostitutes in Ghana. AIDS. 1994 Feb;8(2):239–246. doi: 10.1097/00002030-199402000-00012. [DOI] [PubMed] [Google Scholar]
  4. Bayer R. Public health policy and the AIDS epidemic. An end to HIV exceptionalism? N Engl J Med. 1991 May 23;324(21):1500–1504. doi: 10.1056/NEJM199105233242111. [DOI] [PubMed] [Google Scholar]
  5. Bhave G., Lindan C. P., Hudes E. S., Desai S., Wagle U., Tripathi S. P., Mandel J. S. Impact of an intervention on HIV, sexually transmitted diseases, and condom use among sex workers in Bombay, India. AIDS. 1995 Jul;9 (Suppl 1):S21–S30. [PubMed] [Google Scholar]
  6. Brandt A. M. AIDS in historical perspective: four lessons from the history of sexually transmitted diseases. Am J Public Health. 1988 Apr;78(4):367–371. doi: 10.2105/ajph.78.4.367. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cates W., Jr, Hinman A. R. AIDS and absolutism--the demand for perfection in prevention. N Engl J Med. 1992 Aug 13;327(7):492–494. doi: 10.1056/NEJM199208133270711. [DOI] [PubMed] [Google Scholar]
  8. Choi K. H., Coates T. J. Prevention of HIV infection. AIDS. 1994 Oct;8(10):1371–1389. doi: 10.1097/00002030-199410000-00003. [DOI] [PubMed] [Google Scholar]
  9. Curran J. W., Morgan W. M., Hardy A. M., Jaffe H. W., Darrow W. W., Dowdle W. R. The epidemiology of AIDS: current status and future prospects. Science. 1985 Sep 27;229(4720):1352–1357. doi: 10.1126/science.2994217. [DOI] [PubMed] [Google Scholar]
  10. Darrow W. W. A framework for preventing AIDS. Am J Public Health. 1987 Jul;77(7):778–779. doi: 10.2105/ajph.77.7.778. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Darrow W. W. Approaches to the problem of venereal disease prevention. Prev Med. 1976 Mar;5(1):165–175. doi: 10.1016/0091-7435(76)90018-9. [DOI] [PubMed] [Google Scholar]
  12. Darrow W. W. Behavioral research and AIDS prevention. Science. 1988 Mar 25;239(4847):1477–1477. doi: 10.1126/science.3281250. [DOI] [PubMed] [Google Scholar]
  13. Darrow W. W. Evaluating behavioral interventions for HIV prevention. AIDS. 1996 Mar;10(3):346–348. doi: 10.1097/00002030-199603000-00022. [DOI] [PubMed] [Google Scholar]
  14. Darrow W. W. Veneral infections in three ethnic groups in Sacramento. Am J Public Health. 1976 May;66(5):446–450. doi: 10.2105/ajph.66.5.446. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Fineberg H. V. Education to prevent AIDS: prospects and obstacles. Science. 1988 Feb 5;239(4840):592–596. doi: 10.1126/science.3340845. [DOI] [PubMed] [Google Scholar]
  16. Fisher J. D., Fisher W. A. Changing AIDS-risk behavior. Psychol Bull. 1992 May;111(3):455–474. doi: 10.1037/0033-2909.111.3.455. [DOI] [PubMed] [Google Scholar]
  17. Forer R. Behavioral science activities in a VD program. Public Health Rep. 1965 Nov;80(11):1015–1020. [PMC free article] [PubMed] [Google Scholar]
  18. Friede A., Blum H. L., McDonald M. Public health informatics: how information-age technology can strengthen public health. Annu Rev Public Health. 1995;16:239–252. doi: 10.1146/annurev.pu.16.050195.001323. [DOI] [PubMed] [Google Scholar]
  19. Galavotti C., Cabral R. J., Lansky A., Grimley D. M., Riley G. E., Prochaska J. O. Validation of measures of condom and other contraceptive use among women at high risk for HIV infection and unintended pregnancy. Health Psychol. 1995 Nov;14(6):570–578. doi: 10.1037//0278-6133.14.6.570. [DOI] [PubMed] [Google Scholar]
  20. Gostin L. O. Public health strategies for confronting AIDS. Legislative and regulatory policy in the United States. JAMA. 1989 Mar 17;261(11):1621–1630. [PubMed] [Google Scholar]
  21. Guinan M. E., Farnham P. G., Holtgrave D. R. Estimating the value of preventing a human immunodeficiency virus infection. Am J Prev Med. 1994 Jan-Feb;10(1):1–4. [PubMed] [Google Scholar]
  22. HILL M., MUGGE R. Syphilis prevalence as related to social factors in a Negro subcommunity. Am J Syph Gonorrhea Vener Dis. 1954 Nov;38(6):583–592. [PubMed] [Google Scholar]
  23. Hart G. J. Hope for evidence-based HIV/AIDS prevention? AIDS. 1996 Mar;10(3):337–338. doi: 10.1097/00002030-199603000-00014. [DOI] [PubMed] [Google Scholar]
  24. Hellinger F. J. The lifetime cost of treating a person with HIV. JAMA. 1993 Jul 28;270(4):474–478. [PubMed] [Google Scholar]
  25. Holtgrave D. R., Qualls N. L., Curran J. W., Valdiserri R. O., Guinan M. E., Parra W. C. An overview of the effectiveness and efficiency of HIV prevention programs. Public Health Rep. 1995 Mar-Apr;110(2):134–146. [PMC free article] [PubMed] [Google Scholar]
  26. Jemmott J. B., 3rd, Jemmott L. S., Fong G. T. Reductions in HIV risk-associated sexual behaviors among black male adolescents: effects of an AIDS prevention intervention. Am J Public Health. 1992 Mar;82(3):372–377. doi: 10.2105/ajph.82.3.372. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Joinet B., Nkini W. G. The "Fleet of Hope": offering options to achieve healthy behaviour. AIDS STD Health Promot Exch. 1996;(2):3–6. [PubMed] [Google Scholar]
  28. Kelly J. A., St Lawrence J. S., Betts R., Brasfield T. L., Hood H. V. A skills-training group intervention model to assist persons in reducing risk behaviors for HIV infection. AIDS Educ Prev. 1990 Spring;2(1):24–35. [PubMed] [Google Scholar]
  29. Kelly J. A., St Lawrence J. S., Diaz Y. E., Stevenson L. Y., Hauth A. C., Brasfield T. L., Kalichman S. C., Smith J. E., Andrew M. E. HIV risk behavior reduction following intervention with key opinion leaders of population: an experimental analysis. Am J Public Health. 1991 Feb;81(2):168–171. doi: 10.2105/ajph.81.2.168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Kelly J. A., St Lawrence J. S., Stevenson L. Y., Hauth A. C., Kalichman S. C., Diaz Y. E., Brasfield T. L., Koob J. J., Morgan M. G. Community AIDS/HIV risk reduction: the effects of endorsements by popular people in three cities. Am J Public Health. 1992 Nov;82(11):1483–1489. doi: 10.2105/ajph.82.11.1483. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Kroger F. Preventing HIV infection: educating the general public. J Prim Prev. 1991;12(1):7–17. doi: 10.1007/BF01326538. [DOI] [PubMed] [Google Scholar]
  32. Lefebvre R. C., Flora J. A. Social marketing and public health intervention. Health Educ Q. 1988 Fall;15(3):299–315. doi: 10.1177/109019818801500305. [DOI] [PubMed] [Google Scholar]
  33. Lehmann P., Hausser D., Somaini B., Gutzwiller F. Campaign against AIDS in Switzerland: evaluation of a nationwide educational programme. Br Med J (Clin Res Ed) 1987 Oct 31;295(6606):1118–1120. doi: 10.1136/bmj.295.6606.1118. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Ling J. C., Franklin B. A., Lindsteadt J. F., Gearon S. A. Social marketing: its place in public health. Annu Rev Public Health. 1992;13:341–362. doi: 10.1146/annurev.pu.13.050192.002013. [DOI] [PubMed] [Google Scholar]
  35. Maibach E., Holtgrave D. R. Advances in public health communication. Annu Rev Public Health. 1995;16:219–238. doi: 10.1146/annurev.pu.16.050195.001251. [DOI] [PubMed] [Google Scholar]
  36. Mason J. O., Noble G. R., Lindsey B. K., Kolbe L. J., Van Ness P., Bowen G. S., Drotman D. P., Rosenberg M. L. Current CDC efforts to prevent and control human immunodeficiency virus infection and AIDS in the United States through information and education. Public Health Rep. 1988 May-Jun;103(3):255–260. [PMC free article] [PubMed] [Google Scholar]
  37. Meyer L., Job-Spira N., Bouyer J., Bouvet E., Spira A. Prevention of sexually transmitted diseases: a randomised community trial. J Epidemiol Community Health. 1991 Jun;45(2):152–158. doi: 10.1136/jech.45.2.152. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Mills S., Campbell M. J., Waters W. E. Public knowledge of AIDS and the DHSS advertisement campaign. Br Med J (Clin Res Ed) 1986 Oct 25;293(6554):1089–1090. doi: 10.1136/bmj.293.6554.1089. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Moatti J. P., Dab W., Loundou H., Quenel P., Beltzer N., Anes A., Pollak M. Impact on the general public of media campaigns against AIDS: a French evaluation. Health Policy. 1992 Jul;21(3):233–247. doi: 10.1016/0168-8510(92)90021-3. [DOI] [PubMed] [Google Scholar]
  40. Ngugi E. N., Plummer F. A., Simonsen J. N., Cameron D. W., Bosire M., Waiyaki P., Ronald A. R., Ndinya-Achola J. O. Prevention of transmission of human immunodeficiency virus in Africa: effectiveness of condom promotion and health education among prostitutes. Lancet. 1988 Oct 15;2(8616):887–890. doi: 10.1016/s0140-6736(88)92480-4. [DOI] [PubMed] [Google Scholar]
  41. O'Reilly K. R., Higgins D. L. AIDS Community Demonstration Projects for HIV prevention among hard-to-reach groups. Public Health Rep. 1991 Nov-Dec;106(6):714–720. [PMC free article] [PubMed] [Google Scholar]
  42. Oakley A., Fullerton D., Holland J. Behavioural interventions for HIV/AIDS prevention. AIDS. 1995 May;9(5):479–486. [PubMed] [Google Scholar]
  43. Prochaska J. O., Redding C. A., Harlow L. L., Rossi J. S., Velicer W. F. The transtheoretical model of change and HIV prevention: a review. Health Educ Q. 1994 Winter;21(4):471–486. doi: 10.1177/109019819402100410. [DOI] [PubMed] [Google Scholar]
  44. Rietmeijer C. A., Kane M. S., Simons P. Z., Corby N. H., Wolitski R. J., Higgins D. L., Judson F. N., Cohn D. L. Increasing the use of bleach and condoms among injecting drug users in Denver: outcomes of a targeted, community-level HIV prevention program. AIDS. 1996 Mar;10(3):291–298. [PubMed] [Google Scholar]
  45. Rotheram-Borus M. J., Koopman C., Haignere C., Davies M. Reducing HIV sexual risk behaviors among runaway adolescents. JAMA. 1991 Sep 4;266(9):1237–1241. [PubMed] [Google Scholar]
  46. Simon K. J., Das A. An application of the health belief model toward educational diagnosis for VD education. Health Educ Q. 1984 Winter;11(4):403–418. doi: 10.1177/109019818401100402. [DOI] [PubMed] [Google Scholar]
  47. Slater M. D., Flora J. A. Health lifestyles: audience segmentation analysis for public health interventions. Health Educ Q. 1991 Summer;18(2):221–233. doi: 10.1177/109019819101800207. [DOI] [PubMed] [Google Scholar]
  48. Valdiserri R. O., Aultman T. V., Curran J. W. Community planning: a national strategy to improve HIV prevention programs. J Community Health. 1995 Apr;20(2):87–100. doi: 10.1007/BF02260331. [DOI] [PubMed] [Google Scholar]
  49. Visrutaratna S., Lindan C. P., Sirhorachai A., Mandel J. S. 'Superstar' and 'model brothel': developing and evaluating a condom promotion program for sex establishments in Chiang Mai, Thailand. AIDS. 1995 Jul;9 (Suppl 1):S69–S75. [PubMed] [Google Scholar]
  50. Walter H. J., Vaughan R. D. AIDS risk reduction among a multiethnic sample of urban high school students. JAMA. 1993 Aug 11;270(6):725–730. [PubMed] [Google Scholar]
  51. Wardrop K. A framework for health promotion ... a framework for AIDS. Can J Public Health. 1993 Jan-Feb;84 (Suppl 1):S9–13. [PubMed] [Google Scholar]

Articles from Genitourinary Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES