• Develop a specific behavioral research agenda in STD prevention. Epidemiologic studies are needed to identify the type and prevalence of behaviors that put individuals at risk for transmission or progression of an STD.

  • Identify behavioral risk factors; this work would be facilitated by a national survey of sexual behavior.

  • Determine population rates for STDs, and conduct natural history studies for disease progression in specific, well-characterized populations.

  • Study the psychosocial needs of HIV-positive women and their family systems (traditional and nontraditional, including lesbian women) as they cope with the chronic, crisis-oriented, and usually fatal nature of HIV disease. Give special attention to adolescent psychosocial needs with emphasis on suicide prevention and support strategies.

Characterize the Role of STDs in Adverse Pregnancy Outcomes

  • Study factors such as the infecting pathogen, the stage of gestation during which infection occurs, chronicity of infection, and behavioral patterns such as drug abuse. Organisms should be specifically examined for virulence factors and for other markers associated with specific patterns of fetal or neonatal morbidity.

  • Conduct further studies to demonstrate whether drugs such as acyclovir and zidovudine are safe and effective for use during pregnancy.

  • Direct immunologic studies toward the protective immune responses during breastfeeding to identify the components in breast milk that axe primarily responsible for inhibition of specific pathogens.

  • Similarly, identify the role that breastfeeding plays in the transmission of certain infections such as HIV.

  • Examine such factors as chronicity of infection and stage of gestation during which infection occurs to identify specific pathogens. Improved understanding of the immunobiology of pregnancy and the use of both natural and artificial animal models of STDs in pregnancy are likely to be important to productive research in this area. In addition, organisms should be examined for virulence factors or other markers associated with specific patterns of fetal or neonatal morbidity.

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