261-266 Landry/Forrest

(800,000), syphilis (101,000)2 and trichomoniasis (three million).3 For viral STDs, however, there is no cure; these include human papilloma virus (between 500,000 and one million cases annually), genital herpes (200,000–500,000), sexually transmitted hepatitis B (53,000) and the human immunodeficiency virus, or HIV (which is responsible for 90,000 cases of AIDS annually).4 STDs other than HIV have received relatively little attention, although they may have such consequences as infertility, cancer, infection of offspring and death.5 The federal government spent approximately $89.7 million in 1994 through the Division of STD/HIV Prevention of the Centers for Disease Control and Prevention (CDC) to control the spread of syphilis, gonorrhea, chlamydia and, to a lesser extent, other STDs not including HIV. Some $6.4 million of these funds were combined with $1.9 million from the Office of Population Affairs for targeted gonorrhea and chlamydia testing of family planning clinic clients and other women at high risk for infections leading to infertility; $11 million supported educational programs, STD surveillance, research projects and direct CDC program operations. However, most of the funding ($72.3 million) went to state and local health departments to support STD surDavid J. Landry is senior research associate and Jacqueline Darroch Forrest is senior vice president and vice president for research, The Alan Guttmacher Institute (AGI), New York. Alan Friedlob and Stephen Fitzgerald, Centers for Disease Control and Prevention (CDC), Atlanta, provided helpful advice throughout the project. David Custer, National Association of County and City Health Officials, Washington, D. C., provided information about local health departments. In addition, the authors appreciate the suggestions received from Linda Alexander, formerly with the American Social Health Association, Research Triangle Park, N. C.; Willard Cates, Jr., Family Health International, Research Triangle Park, N. C.; Leslie M. Hardy, formerly with the Institute of Medicine, Washington, D. C.; Edward W. Hook III, University of Alabama, Birmingham; Vivian Lee, formerly with the U. S. Public Health Service, Region X, Seattle; Kathleen E. Toomey, Georgia Department of Human Resources, Atlanta; and Gillian Vanblerk, Prince Georges County Health Department, Cheverly, Md. The authors thank Lisa Kaeser, AGI, Washington, D. C., for her input into the development of the survey and Kathleen Manzella, Thu Vu and Heidi Jones, AGI, New York, for their assistance in fielding the survey and in data tabulation and analysis. The research on which this article is based was supported by the U. S. Department of Health and Human Services (DHHS) under grant FPR000057, through an interagency agreement with the CDC. The conclusions and opinions expressed in this article do not necessarily represent the views of DHHS or the CDC. Public Health Departments Providing Sexually Transmitted Disease Services