Gap Between Science and Program

Prevention of Sexually transmitted diseases (STD) necessitates the development, implementation and maintenance of scientific evidence based public health programs. However, there is a multidimensional gap between scientific findings and STD prevention programs. Science focuses on individual pathogens whereas STD programs need to control and prevent the spread of all sexually transmitted pathogens; science focuses on either the prevention of spread or the prevention of sequelae, whereas STD programs need to prevent both spread and sequelae; most science focuses on treatment and prevention at the individual level, whereas STD prevention programs need to control and prevent spread and sequelae at the population level; science focuses on individual interventions whereas STD programs need to implement a multiplicity of interventions; science evaluates interventions at a specific point in time in the evolution of epidemics, whereas STD programs need effective interventions during all phases of epidemics; science evaluates interventions among a narrowly defined group of eligibles and only among those who agree to participate in the study, whereas STD programs need interventions that work well in all groups, often particularly among those who are ineligible or those who refuse to participate in research; science evaluates interventions under ideal conditions, whereas STD programs need to implement interventions under “everyday” often far-from-ideal conditions. These and several other parameters of the science – program gap are important to identify so that future efforts may bridge these gaps and forge effective science – program collaborations in STD research.