King K. Holmes, an infectious disease specialist at the University of Washington who almost single-handedly legitimized the study of sexually transmitted infections, turning a neglected, stigmatized subject into a major field of medical research, died on March 9 at his home in Seattle. He was 87.
The cause was kidney disease, his family said.
Once called “Mr. STD” by a colleague, Dr. Holmes founded some of the first clinics that specialized in treating sexually transmitted infections; pioneered the use of single-dose medicines to prevent illness after intimate encounters; and published the field’s definitive textbook, often referred to simply as “Holmes.”
“He brought sexually transmitted diseases out of the closet,” Judith Wasserheit, his colleague at the University of Washington, told The Seattle Times in 2013. “King did pivotal research on almost every aspect, every single STD, every diagnostic or treatment.”
Dr. Holmes began studying sexually transmitted diseases in the 1960s, the era of sex, drugs and rock ’n’ roll, which coincided with a surge of rashes and discharge in certain anatomical areas that patients and physicians were equally squeamish about discussing.
“This was not a well-developed specialty or an area of study in infectious disease,” Peter Piot, a global health expert who led an AIDS-prevention program for the United Nations, said in an interview. “There was no funding for it. Nobody liked talking about it.”
Dr. Holmes publicly challenged the medical community to do better. In interviews, he called the lack of interest in the study of sexually transmitted diseases a “conspiracy of silence” that was “ignorant,” “appalling” and “a disgrace.”
He also brought a frank, down-to-earth tone to an uncomfortable topic. His first book, written with Jennifer Wear, was titled “How to Have Intercourse Without Getting Screwed” (1976). A review in The Western Journal of Medicine quoted a passage from the book to illustrate its friendly tone:
“Ever wonder why crabs concentrate in the pubic area? One theory is that crabs like to have intercourse, just like the rest of us. To do it, the male and female crabs have to grasp adjoining hairs two millimeters apart, and the spacing of the hairs is just about right in the pubic area. Crabs cannot jump and they cannot reach very far even when they stand on their tip-toes, so the only way to catch them is for your pubic hair to come within about two millimeters’ distance from someone else’s pubic hair or from where someone else’s pubic hair has recently been. When the crab’s tummys are full, they do occasionally drop off into your underpants, sheets, or sleeping bag, and curl up for a little nap … if you use a crab victim’s clothing, bed, or sleeping bag within a day after he did, you could get screwed even without having intercourse.”
The book won praise from the medical community.
“It is informative, competently written, quite relevant, and scientifically and socially correct,” the Western Journal’s reviewer, H. Harrison Sadler, a professor of medicine at the University of California, San Francisco, wrote. “Those who have picked it up off my desk have not put it down until they have completely read it and all smiled when they returned it.”
By talking disarmingly about sex, Dr. Holmes was able to bring together disparate groups of experts — epidemiologists, microbiologists and physicians — to work on novel treatments and prevention methods.
In the early 1970s, he formed a partnership between the University of Washington and the Seattle and King County Department of Public Health to open a treatment clinic for sexually transmitted infections, giving researchers the ability to analyze patient data. The alliance was a template for other academic-public health partnerships combating infectious diseases.
Dr. Holmes helped establish a similar multidisciplinary clinic in Seattle in the 1980s, during the AIDS crisis.
“Holmes’s superpower,” Mary Engle wrote in “Hot Spot: How Seattle Became the Place for Infectious Diseases Research” (2022), “was a big-picture mind that could make connections no one else saw — whether evaluating the data in a single research project, merging university and county-health interests, or broadening the field of infectious diseases itself.”
King Kennard Holmes was born on Sept. 1, 1937, in Ramsey, Minn. He was named after his grandfather, Wesley E. King. His father, Robert Holmes, was an engineer; his mother, Catherine (King) Holmes, oversaw the household.
Dr. Holmes graduated from Harvard University in 1959. He received his medical degree from Cornell University in 1963 and a doctorate in microbiology from the University of Hawaii in 1967.
He had no intention of studying sexually transmitted infections when he began practicing medicine. Drafted into the Navy during the Vietnam War, he was stationed at a preventive medicine unit in Pearl Harbor, where he served as an epidemiologist for the Navy’s Seventh Fleet.
“When I arrived at my desk, there was a stack of reports waiting for me about incurable gonorrhea in the Seventh Fleet,” he said in an interview with the medical journal The Lancet in 2007. “The main epidemiological problem was penicillin-resistant gonorrhea. That’s the way I first became involved in STD research.”
His first major study was aboard the U.S.S. Enterprise.
“When the ship went into port for three or four days, the men would go on liberty, and some had sex with sex workers,” he said.
After the ship left port, hundreds of sailors would show up at the medical bay with urethral discharge. Dr. Holmes had an idea: to treat the men with a single dose of an antibiotic after a sexual encounter, a method that had been endorsed and is still recommended today by the Centers for Disease Control and Prevention and the World Health Organization.
Following his Navy service, Dr. Holmes joined the University of Washington in 1967, working first as a clinician and later as a researcher. His efforts were local, national and global.
In addition to opening S.T.I. and H.I.V. clinics in Seattle, he helped start a national surveillance system for gonorrhea, identifying at-risk populations. His H.I.V. research took him to sub-Saharan Africa and Latin America.
In 2013, Dr. Holmes stepped down as chairman of the University of Washington’s department of global health.
“There is nobody in the world like King,” Matt Golden, a public health official in King County, Wash., told The Seattle Times that year. “He’s been a leading figure in the field since he was a young man. How many people are at the top of their field for 40 years?”
Dr. Holmes’s marriage to Linda Haas in 1959 ended in divorce. He married Virginia Gonzales, a clinical social worker, in 2016.
She survives him, as do two children from his first marriage, Heather Jellerson and King Kennard Holmes Jr.; two brothers, Robert Jr. and Eugene Holmes; and three grandchildren.
Dr. Holmes conducted 40 clinical trials, published more than 500 peer-reviewed papers and wrote 178 book chapters, but he and his colleagues considered his most enduring legacy to be the 170 scientists whom he trained and mentored.
“This is a man who has fathered the field, and his ‘children and grandchildren’ are now leaders in the field,” Dr. Wasserheit told The Seattle Times. “His impact has been profound.”
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