概述-历史记载   Introduction - Historical Notes

波动的性传播疾病发病率

1950年代，在美国抗生素的使用，加之大规模公共教育运动，导致性传播疾病发病戏剧般的下降。但是，这种成功激起了反常的反应：许多医学权威人士和政客担心，一旦“罪恶的报应”被排除，男男女女们可能转向乱交、放荡和堕落。结果就是婚姻、家庭和作为整体的社会将面临崩溃和衰落。从这个意义上看，“治愈疾病将比疾病更糟”。

无论如何，美国政府在1950年代也或多或少受到疾病治疗表面看起来简单的误导，开始逐渐加大力度削减性传播疾病的预防项目。与此同时，社会和政治氛围使公开讨论性问题变得越来越困难了。

不幸而又可预见的是，性传播疾病感染率再次上升。因而，美国失去了控制性传播疾病发病率的唯一历史机遇。一系列疾病防治失控的局面再度出现，没有了足够可资利用的有效治疗措施。疾病预防项目也必须对应人们的性行为做出调整，而且这些项目必须不间断地坚持下去。

美国：1950年代，性传播疾病病例的戏剧性下降及其随后的急剧上升
USA: A dramatic drop in STD cases in the 1950s, followed by a steep rise

一期和二期梅毒（单位：千）
Primary and secondary syphilis (in thousands)

淋病（单位：千）
Gonorrhea (in thousands)

Source: Allan M. Brandt, No Magic Bullet - A Social History of Venereal Diseases in the United States since 1880,
Oxford University Press, 1987

Falling and rising STD rates

In the 1950s, the use of antibiotics together with a massive public education campaign, led to a dramatic decline of STDs in the United States. However, this success provoked a paradoxical reaction: Many medical and political authorities feared that, once “the wages of sin” had been eliminated, men and women would turn to promiscuity, debauchery, and vice. As a result, marriage, the family, and society as a whole would face ruin and decline. In that sense, “the cure would be worse than the disease”.
In any case, in the early 1950s, the U.S. government, in part also misled by the apparent simplicity of a cure, began ever more drastic cuts in its STD prevention programs. At the same time, the social and political climate made the open discussion of sexual issues more and more difficult. Unfortunately, and predictably, the infection rate rose again. Thus, a unique historical opportunity was lost to get American STD rates under control. The episode also proved once again that it is not enough to have effective treatments available. Prevention programs must also address the issue of human sexual behavior, and they must do this continuously.