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Willard Cates, Jr, MD, MPH

JAMA. 1986;255(13):1769.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Recent concern about increasing budget deficits has led some policymakers, health planners, and clinicians to reconsider the issue of public support of sexually transmitted disease (STD) clinical services. Moreover, the expanded spectrum of sexually transmitted organisms—especially the specter of human T-cell lymphotropic virus type III—has placed heightened demands on already-limited resources. Arguments to limit public resources have generally contained five overlapping themes¹:

1. Disincentive to Prevention.—"Free" clinics encourage disease-prone behavior (such as nonuse of condoms) by removing the cost incentive.
   
2. Promotion of Irresponsible Behavior.—"Free" clinics "foster" sexual irresponsibility; it is unfair to expect taxpayers to underwrite the sequelae of "irresponsible sex."
   
3. Better Use of Funds.—"Free" STD clinics compete for limited public health resources, which would be better applied to more cost-effective preventive interventions.
   
4. No Public Health Threat.—Sexually transmitted diseases pose no general threat to the public at large; the "truly innocent victims" are few in number and
   

Author Affiliations
Centers for Disease Control Atlanta

Footnotes
Address editorial communications to the Editor, 535 N Dearborn St, Chicago, IL 60610.

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