Preventing sexually transmitted diseases through individual- and population-based public health approaches: Social and political implications

Epidemiology provides the scientific rationale for public health decisions. Epidemiologists construct taxonomic collectives on the basis of individual attributes, or ''risks.'' One of the public health approaches to the control of sexually transmitted diseases (STDs) is to identify population-based strategies that can be targeted to these risk groups. Public health decisions, however, are largely political and open to discussion beyond the academic environment. Terms such as ''risk group'' have different meaning in public discourse than in scientific jargon. The language of epidemiology, when used in public health campaigns to control STDs, has led to stigmatization and victimization of individuals. Public health policies that ignore the political and social organization of populations are in danger of becoming instruments of social and political repression.