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. Outstanding in 2010 are the challenges caused by the economy on top of an already stressed public health system. Long time approaches that do not always work along with limited resources force STD programs to make tough choices about what can actually be addressed. 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 representing different geographic areas and STD leadership roles. Audience opinion about how to address problems along with opinions of experts will create a rich discussion aimed at helping public health departments address critical STD prevention problems.