Would legalizing prostitution cut down STD transmission?

Q: Phil: My question is about legalizing prostitution and testing for STDs. Even if we gave prostitutes weekly exams for sexually transmitted diseases, how could we be sure that someone wouldn't get infected from a client midweek and then pass it on to other customers for the rest of the week?

A: Dr. Dean: That is possible, but just because a person is infected with an STD doesn't mean he's going to be infectious right away. It usually takes a little longer than a few days. In some places where prostitution is legal, tests are done weekly, in other places monthly.

When we're talking about legalizing prostitution, at least one of things we have to look at is the impact on public health.

When the first AIDS cases were reported in Germany, they didn't have the problems that we had here in terms of the disease being spread by prostitutes. We just spread it all over this country because here prostitution is an underground thing.

In Germany, they rounded up all the prostitutes, 100 percent of them, and tested them all for HIV. Then they continued to test them, and they treated them and got them off the marketplace.

There is no doubt in any rational person's mind that we don't like prostitution. It really doesn't make anybody ha ppy, and we would all like to see a world where it doesn't exist. That said, let's recognize that after 5,000 years, we're not going to make it go away, and we need a saner approach to the issue.

Prostitution affects all of us. There are innocent women out there whose husbands come home with HIV and give it to them. We can blame the husband and say it's his fault, but from a public health perspective, we could have done a lot and could do more in the future with a program that legalizes prostitution and tests prostitutes.

Dean Edell, M.D.

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