The main public health functions can be broadly classified as medical, edidemiologic and educational. In the medical phase, public health activities are geared to early case recognition and early treatment of known cases. Blood testing programs are carried out where experience has shown a good yield of unknown syphilis cases. Therefore many blood testing programs are to be found in certain industries, most general hospitals, jails, juvenile halls, migrant labor areas and in certain neighborhoods where venereal diseases appear to be near epidemic proportions. These blood testing programs are additional to the premarital and prenatal requirements. Another state law requiring drops to be put into the baby's eyes at birth helps prevent blindness from gonorrhea. The most important function of Public Health, however, is what we call "epidemiology." In this phase of activity, through confidential means, we try to locate all known contacts of infectious cases of venereal disease and help them seek medical examination and treatment if necessary. When contacts to infectious cases are located, they are informed of their exposure, but the name of the person to whom they were exposed is not disclosed. Since in most instances persons who have been exposed are not aware of any symptoms, it is important that they obtain examination and treatment immediately, before the disease "takes hold" or can be spread to other intimate contacts. For this examination änd treatment, either the person's personal physician or public health facilities are available.

The main educational activities of public health are directed at younger age groups who acquire the majority of VD infections, so they will know the facts of venereal disease and what to do when they may have been exposed.

How do the U.S. Public Health Service, the State Health Department and the local City and County Health Departments carry out venereal disease programıs?

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The Public Health Service mostly provides funds and workers to help local and State health departments with the activities outlined above. The State Health Departments generally provide consultation and coordinate activities. For example, in California, meetings of local health department venereal disease workers are held on a regional basis, so that ideas and programs can be shared. This is particularly important since venereal diseases often cross county, state and even international boundaries. A person can be exposed to syphilis in San Francisco by another person who goes to Los Angeles where the disease is discovered. In Califomia, local city and county health departments carry

mattachine REVIEW

out the day-to-day personal activities of venereal disease work. This consists of work with physicians, hospitals, patients and contacts. Always their goal is finding as many cases and contacts as quickly as possible so they may be examined and treated. Confidentiality is essential in these activities. Educational programs are carried out by local health agencies who often request assistance from the State or Federal Public Health organizations.

Are public health facilities open to homosexuals?

They certainly are and it is important to realize that strictest confidence is not only provided but is necessary in our work. Every month in California at least a couple of thousand homosexuals avail themselves of public health facilities. Recently I attended the World Forum for Syphilis in Washington, D.C., and there I learned that this is not peculiar to California. Throughout the nation, many thousands of homosexuals are availing themselves of public health venereal disease facilities. As important as knowing your own doctor, we feel everyone should get acquainted with the local health department.

What is the general reaction of homosexuals to public facilities-are they satisfied with the service they receive?

The vast majority of homosexuals attending facilities are well satisfied-best illustrated by the many "satisfied customers" who return to clinics without hesitation. Many sexually active persons come in regularly for diagnostic check-ups. Naturally we occasionally have problems with homosexuals as well as with "straight" men and women who are unhappy when we find they have gonorrhea of the penis, rectum or cervix; or merely unhappy that we know they have been having sexual relations for which they need an examination. This, however, is the small minority of patients seen in clinics and I would guess are those who "complain" to One, Inc., Mattachine and other organizations. The fact that the vast majority are satisfied is illustrated not only by the many patients who intelligently come in every month or so but also tell their friends to come in.

· Which is preferable, a public health clinic or a private physician? Whichever is most convenient for the patient. If a patient has a personal physician, he should not hesitate to go to him and relate his problem to him. If money is a problem in visiting a private physician, most health departments have clinics available without charge or embarrassment and where the strictest confidence is kept.

Does the health department have any relationship to police agencies?