SUMMARY Past sexually transmitted disease (STD) control efforts in the United States of America have generally permitted a timely response to changes in intervention technology, antibiotic resistance, public funding, and media interest.' 2 Today, however, the expansion of STD organisms and syndromes at logarithmic rates has taxed our traditional labour intensive control approaches. We describe briefly the history of STD control strategies in the United States, discuss the seven components upon which current efforts are based, and speculate about our future programme initiatives.History National programmes to control STD were established in the USA during the early days of the first world war.' For the next half century the focus was almost exclusively on the control of syphilis and its complications. Federal grants to support STD control initiatives were begun in 1939. Rapid treatment centres for syphilis and gonorrhoea were the second world war responses to a perceived STD problem. Widespread availability of penicillin led to a dismantling of the rapid treatment centres and a dissolution of the clinical specialty of venereology, which had largely been syphilology. During the 1950s and 1960s, however, federal assistance continued to support the tracing of sexual partners, serological screening, and patient education services. The STD "epidemiologist" emerged as a central figure in syphilis control efforts.By the late 1960s officials had become concerned with the rapidly escalating number of cases of gonorrhoea. Selective culture media stimulated the development of a national gonorrhoea control strategy.2 Pilot projects were undertaken in six American cities to identify infected women and also to treat the sexual partners of infected men. These projects showed the feasibility of such an approach. In 1972 the federal government dramatically increased its financial assistance to STD control. At the expense of syphilis, gonorrhoea gradually received a larger portion of the federal STD grant during the re-