This page outlines what sexual health actually means,
as a way of deepening our understanding of
the idea and placing the contents of this
website in a wider context.
Often, sexual health is
discussed only with reference to medical
issues, but
www.sex-and-relationships.com
draws on much broader concepts of what
constitutes sexual health. This approach
lends itself to presenting material ranging
from relationship skills and ways of
negotiating sex, right through to
information about anatomy, psychosexual
difficulties and gender issues.
The Independent Advisory
Group on Sexual Health and HIV (Department
of Health 2005) in the UK suggested that a
range of health issues fall under the
heading of Sexual Health, namely:
contraception, abortion, psychosexual
services and the detection and treatment of
sexually transmitted diseases (STDs or STIs),
including HIV.
The definition shown below
comes from the UK Department of Health
(2001) and includes emotional issues, such
as living in a fulfilling sexual
relationship and being free from
discrimination, as important aspects of
sexual health.
Sexual health is an important part
of physical and mental health. It is a key
part of our identity as human beings,
together with the fundamental human rights
to privacy, a family life, and living free
from discrimination. Essential elements of
good sexual health are equitable
relationships and sexual fulfillment with
access to information and services to avoid
the risk of unintended pregnancy, illness or
disease. (Department of Health 2001.)
Unfortunately, such an
inclusive view is the exception rather than
the norm, as sexual health was traditionally
- and indeed is often still - approached from a medical
perspective. Therefore, sexual health in the
UK is most often equated with rates of STDs
or abortions.
Since the last major sexual
health promotion campaign in the 1980s,
which was
sparked by concerns about HIV, rates of
sexually transmitted
diseases have been steadily increasing
in Britain. For example, recent
figures show that the number of new episodes
of STDs diagnosed in England, Wales and
Northern Ireland has doubled between 1994
and 2004. These include increases in gonorrhoea
(up by 148%), chlamydia (195% increase) and
infectious syphilis (up by 380%) (Department
of Health 2004).
The Independent Advisory Group
for Sexual Health and HIV suggested that
prevention is better than cure as it would
save on health care costs as well as on
lives (Department of Health 2004). The
financial figures they quote estimate the
cost of sexual health problems in the UK as
£2.5 billion for unwanted pregnancies and £1
billion to care for new HIV cases diagnosed
in 2002 and 2003. In addition, STDs and
their potential complications cost the National
Nealth Service
over £1 billion per year.
For young people
the figures for STD infections are even
higher due to their greater risk taking behaviour and vulnerable physiology. Carvel
(2007), reporting on a study linking drug use
amongst young people with a crisis in sexual
health in the UK Guardian newspaper, stated that
'In a single act of unprotected sex with
an infected partner, adolescent girls have a
1% chance of acquiring HIV, a 30% chance of
getting genital herpes and a 50% chance of
contracting gonorrhea' (Carvel 2007).
Clearly, the extent of only the medical
aspects of the problem around sexual health
in the UK alone is staggering.
Additional figures reveal the
frequency of psychosexual conditions in
Britain. Nazareth et al (2003) conducted a
survey of patients attending London general
practitioners. They found that the most
common
psychosexual problems for men are
erectile failure and lack or
loss of sexual desire, and for women a lack
or loss of sexual desire and
failure of orgasmic response. They
conclude that sexual difficulties are common
in people attending general practitioners.
The findings of Nazareth et al (2003) are in
line with an earlier study by Mercer et al
(2003) who reported the results of the UK
national survey of sexual attitudes and
lifestyles around sexual function
problems. They found that the most common
psychosexual issues for men are lacking
interest,
premature orgasm and performance
anxiety. For women the most common problems
are lack of interest, inability to
experience orgasm, and
painful intercourse. Mercer et al (2003)
concluded:
'Our data have
implications for improving relationship
education, counseling, medical education,
and doctor’s professional development;
raising public awareness of the range and
location of service available for managing
sexual problems; and re-examining the nature
of "sexual dysfunction" and how best to
tackle it.' (Mercer et al 2003: 427).
The above figures must be set
in context with the current provision of
sexual health services in Britain.
Traditional services such as GUM (Genito-urinary-medicine) clinics
seem to be struggling to cope with demand
and may need an increase in capacity of 30 –
50% (BBC 1 2005) to keep abreast of new
infection rates. And of course, people in
Europe must be considered to be the lucky
ones as virtually everybody has free access
to medical care.
The Independent Advisory
Group for Sexual Health and HIV has
recommended more action on STDs and HIV by
'stripping away the stigma and making
prevention a key part of the nation’s
broader public health agenda.' (Department
of Health 2004: Press release).
Internationally, sexual health is also a
major concern with the most obvious crisis
being the AIDS/HIV epidemic in Sub-Saharan
Africa (Bancroft 1989, Coleman 2002, Donovan
2004, New Scientist 2006, Low et al 2006, Wellings et al 2006, Bearinger et al 2007,
Carvel 2007).
Clearly, sexual health is a
major national and international concern,
which needs to be addressed through
prevention and education and not just with more
medical resources (Department of Health
2004). But the medical costs alone are
challenging for even wealthy nations to
manage. Additionally, sexual health cannot
be restricted to physical health alone, but
must include psychological issues such as
relationship skills and sexual identity. The
Department of Health’s (2004) reference to
'stigma' suggests that a lack of openness in
many societies has contributed to a
decline in sexual health over the last 10
years.
Sex-and-Relationships hopes
to provide an innovative and frank service
which encourages people to inform
themselves, ask questions, and receive
answers about all aspects of sexual health.
Thereby we hope not just to support people
who have problems, but also encourage
individuals to inform themselves and develop
'good sexual health' in a preventative way
so that sexuality becomes an expression of
their
human potential and integrity.
References:
Bancroft, J. (1989) Human
sexuality and its problems. Second edition.
Edinburgh: Churchill Livingstone, Elsevier
Health Sciences
Bearinger, L.H., Sieving, R.E.,
Ferguson, J., Sharma, V. (2007) Global
perspective on the sexual and reproductive
health of adolescents: patterns, prevention,
and potential. Lancet 369, 1220-31
BBC1 (2005) ‘Love hurts’
Programme broadcast on the 16.10.2005 in the
Panorama series
Carvel, J. (2007) Study links
drug use with crisis in sexual health. The
Guardian 15th of June
Coleman, E. (2002) Promoting
sexual health and responsible sexual
behavior: An introduction. The Journal of
Sex Research 39, 1, 3-6
Department of Health (2001)
The national strategy for sexual health and
HIV
Department of Health (2005) Independent
advisory group on sexual health and HIV.
Annual Report 2004/2005
Donovan, B. (2004) Sexually
transmissible infections other than HIV.
Lancet 363, 545-56
Low, N., Broutet, N.,
Adu-Sarkodie, Y., Barton, P., Hossain, M.,
Hawkes, S. (2006) Global control of sexually
transmitted infections. Lancet 368, 2001-16
Mercer, C.H., Fenton, K.A.,
Johnson, A.M., Wellings, K., Macdowall, W.,
McManus, S., Nanchahal, K., Erens, B. (2003)
Sexual function problems and help seeking
behaviour in Britain: national probability
sample survey. British Medical Journal, 327:
426-427
Nazareth, I.,
Boynton, P., King, M. (2003) Problems with
sexual function in people attending London
general practitioners: cross sectional
study. British Medical Journal 327:423 (23
August)
New Scientist (2006)
Abstinence fails. New Scientist 19th of
August 2006
Wellings K., Collumbien, M., Slaymaker, E.,
Singh, S., Hodges, Z., Patel, D., Bajos, N.
(2006) Sexual behaviour in context: a global
perspective. The Lancet 368, 1706-28
Extract of doctoral thesis,
edited for the web by Anna 17.08.09
Support This
Project!
Sex and
relationships.com
tries to offer good
advice and
trustworthy
information to as
many people as
possible.
If you like our
project, please
support us
from
your website, blog
or forum, or email
others to let them
know about us!
