STD prevention programs have evolved over the years but constantly face obstacles to full success. These obstacles change over time depending on the economic, socio-political climate as well as the epidemiology of particular infections. For example, in recent years, syphilis has decreased overall but increased in the population of men who have sex with men. New organisms have been identified and new laboratory tests have become available, but resources are limited and tough choices must be made about what can actually be addressed. Many services have been routinized in programs but may no longer be effective. This session will challenge the audience and its panelists to address current tough challenges in STD prevention for which there are no clear answers. Specific questions that reflect these challenges will be posed to panelists and the audience. Panelists representing expertise in public health science and program will offer responses. The audience, through an automated audience response system, will also offer their opinions. Panelists will include public health leaders from different geographic and leadership roles (e.g., public health management, medical, epidemiological, etc.). Audience opinion about how to address problems along with opinions of experts will create a rich discussion aimed at helping public health department leadership address critical STD prevention problems