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Straight Dope 

I am getting married later in the year and to do so must get a blood test. What is the purpose of this? What kind of information could the government possibly be looking for? Is this test to ensure that Americans aren't running around marrying their kin? --Engaged but Confused in Los Angeles

Got news for you, kid. Premarital blood tests haven't been required in California since 1994. The test used to be required to ensure that you and your betrothed were free of venereal disease, chiefly syphilis. The tests were a holdover from a New Deal-era anti-VD campaign and were once required in virtually all states. But maybe a third have now repealed the requirement, on the grounds that the handful of cases detected doesn't justify the exorbitant expense.

Venereal disease was one of a handful of maladies (tuberculosis was another) that were deemed to have such horrible public-health consequences that they justified compulsory testing and other drastic measures. According to VD historian Allan Brandt (No Magic Bullet, 1985), a 1901 study claimed that 80 percent of New York City men had been infected with gonorrhea and 5 to 18 percent had syphilis. These numbers were probably exaggerated (then, anyway), but maybe not by much. In 1909 VD afflicted nearly 20 percent of army recruits and accounted for a third of all sick days. In the 1920s 500,000 new cases of syphilis and 700,000 cases of gonorrhea were reported each year. Some experts believed VD was more widespread than all other infectious diseases combined.

The first effective treatment for syphilis had been discovered in 1909 but wasn't widely used, partly because of side effects, but also because of reluctance to deal with the subject openly. Moralists viewed the situation with growing alarm, fearing that men would all get the clap from hookers (who, in fact, had high infection rates) and subsequently infect their innocent brides. The women would then pass the disease along to their babies or become sterile, and poof--there goes the human race, or at least the white middle-class part of it. To this day newborns get silver nitrate drops in their eyes to prevent blindness due to maternal gonorrhea, which at one time accounted for 25 percent of all blindness in the U.S.

During the late 1930s surgeon general Thomas Parran was able to overcome national squeamishness and crank up an anti-VD crusade similar to that surrounding AIDS 50 years later. One result of his efforts was the requirement of premarital VD testing by the states, starting with Connecticut in 1935.

The only problem with these tests was that they didn't turn up many cases of venereal disease. Even in New York City, that festering sink of promiscuity, the positive rate for syphilis during the first year of compulsory testing was only 1.34 percent. In part that was because many couples sought to avoid the expense by getting their marriage licenses in neighboring states that didn't require testing. And of course it's possible the prevalence of the disease was exaggerated. But probably the main reason was that the respectable types who got marriage licenses were at low risk for sexually transmitted disease (or at least for the STDs being tested for).

Some anti-VD measures were more successful. VD testing of pregnant women, for example, greatly reduced the incidence of congenital syphilis. But premarital testing has largely been a waste. A study in California found that of 300,000 persons tested in 1979, just 35 cases of syphilis (0.012 percent) were found--at a cost of $240,000 per case.

The ineffectiveness of premarital VD testing deterred most states from requiring tests for today's sexual scourge, HIV. Only two states, Illinois and Louisiana, enacted premarital HIV testing laws, and both repealed them when, predictably, few new cases turned up. Illinois repealed its syphilis testing requirement at the same time. A lot of people apparently are unaware that California repealed its requirement as well--even the folks at the state department of health services were surprised when we inquired about this. If some local county clerk gives you grief, tell him to look up Assembly Bill 3128, approved by the governor July 15, 1994.

--CECIL ADAMS

Is there something you need to get straight? Cecil Adams can deliver the Straight Dope on any topic. Write Cecil Adams at the Chicago Reader, 11 E. Illinois, Chicago 60611, or E-mail him at cecil@chireader.com.

Art accompanying story in printed newspaper (not available in this archive): illustration/Slug Signorino.

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