EXECUTIVE SUMMARY Background

Sexually transmitted diseases (STDs), including HIV, are common, important, and preventable causes of morbidity, mortality, disability, lost-productivity, and health care costs. In the United States, more than 65 million individuals are living with an STD, the majority of which are incurable viral infections. Approximately 15 million new sexually transmitted infections occur annually in the U.S. In the United States, approximately 493,000 individuals have died from AIDS, and 800,000-900,000 people are living with HIV disease. Many sexually transmitted infections can cause adverse pregnancy outcomes including miscarriages, stillbirths, intrauterine growth restriction and perinatal (mother-to-infant) infections. Some STDs can cause infertility or lead to ectopic pregnancy among women and one, the human papillomavirus, can cause cervical and anogenital cancer. Furthermore, other STDs facilitate HIV transmission. The Problem and the Process Primary prevention of STD infection is an important health priority. Unfortunately there are no STD vaccines, except for hepatitis B vaccine, and topical microbicides to prevent STDs are not available. Beyond mutual lifelong monogamy among uninfected couples