Social and psychologic aspects of the sexually transmitted diseases: a different view.

A sociologic model is presented which interrelates four major variables: health providers, health consumers, the sociocultural environment, and social exchange. This model is proposed as an alternative to the prevailing medical model where the patient is pictured as a passive carrier who presents a problem to the competent physician to define, treat and control. In contrast to the epidemiologic model, the new model puts the health professional on the same level as the patient and demands that we take a critical look at our own values and behavior as well as that of the patient community. Studies are presented which indicate that in the United States there is much left to be desired in our performance as far as screening, diagnosis, treatment, reporting and follow-up of sexually transmitted diseases (STDs) are concerned. We have a tendency to dismiss the reasons for noncompliance of patients as "poor excuses" but we are probably even less compliant in doing what should be done to control STDs. Setting realistic goals and accepting the challenge of solving this problem are essential.