Sexually transmitted diseases remain uncontrolled although millions of cases occur annually in the United States. The advent of acquired immunodeficiency syndrome (AIDS), which is also a sexually transmitted disease, has not altered this situation. The major portion of federal funding for sexually transmitted diseases is allocated to a search for an AIDS vaccine or cure. State health department funding for sexually transmitted diseases, although only a small fraction of the $1.3 billion AIDS research budget of the National Institutes of Health, is largely consumed by AIDS. A single adequately funded sexually transmitted disease control program that applies well-established public health principles for the control of communicable diseases would make sense. However, a consensus to develop and support such a program does not exist in the United States.

BACKGROUND: No representative surveys of scientific opinion about blind review have been published, and there is very little information on the success of the blinding process. The American Journal of Public Health has practiced blind review since 1977. METHODS: In 1989 to 1990 312 of its reviewers were asked to identify author and institution in the manuscript they reviewed, to provide clues to such identification, to express their opinion concerning blind review, and to offer reasons for their opinion. RESULTS: Reviewers claimed to be able to identify author and/or institution in 47% of the 614 chances offered; identification was incorrect 16% of the time, overall identification correct 39% of the time. Self-referencing was the clue to identification in 62%, personal knowledge in 38% of the cases. If only personal knowledge cases are considered, blinding was successful 83% of the time. Blinding was favored by 75% of the reviewers with most asserting it eliminated bias. Reasons given for opposing blind review included the following: blinding not possible, identification will not influence judgment, and its obverse, identification assists judgment. CONCLUSIONS: For the American Journal of Public Health blinding is usually, but not always, successful; and the majority of its reviewers favor current policy. Until more definitive data are in, reviewer preference, which differs from journal to journal, seems the most legitimate guide to journal policy on blind review.