The promotion of sexual health should enhance sexual and emotional well-being and help people to reduce the risk of sexually transmitted diseases (STDs) and unwanted pregnancy. Sexual health includes a broad range of important health issues (see below under the section 'Sexual health needs'), many of which are considered priorities for the NHS. Encouraging open and discreet access to all at-risk groups (including teenagers and minority groups) and explicit confidentiality procedures are essential to encourage service uptake.¹

Sexual health needs

Sexual health needs may be associated with:

• Detecting and managing STDs, including HIV, chlamydial genital infection, genital herpes simplex, gonorrhoea and syphilis.
• Contraception advice and provision.
• Pregnancy testing and support.
• Termination of pregnancy services, including support and counselling.
• Sexual dysfunction, including erectile dysfunction, premature ejaculation, vaginismus and orgasmic problems in women (see also separate article Sex Therapy and Counselling).
• Related problems, e.g. infertility - see separate articles Male Infertility, Female Infertility, Subfertility Investigations and Management and Subfertility Treatments.
• Experiences such as sexual assault or coercion.
• Psychological problems, including poor self-esteem and dependent personality.

Risk factors

Specific action should recognise and meet the needs of particular groups of people, such as:¹

• Young people who are, or are contemplating becoming, sexually active:
  • Teenage conception and abortion rates remain consistently high.
  • Rising numbers of new STDs among those in their teens and early twenties.
• Homosexual men:
  • There is now an increasing number of newly diagnosed HIV infections. A significant number of those with HIV are unaware they are infected.
  • High rates of STDs are also diagnosed, especially gonorrhoea and syphilis.
• Black and minority ethnic communities:
  • A disproportionate number of STDs, including HIV, in some black and minority ethnic communities in England.
• Other individuals, who may have higher levels of sexual health needs or who may have access to services: these might include people with disabilities, those with learning difficulties, refugees and asylum seekers, homeless people, people in custodial settings and young people who are in care or are leaving care provision.

Promoting sexual health¹

• People should have prompt access to a full range of sexual health services and to comprehensive information on local sexual health service provision.
• People should be provided with information and support to assess their personal risk, and to access and use services effectively.
• The promotion of sexual health should enhance sexual and emotional well-being and help people to reduce the risk of STDs and unwanted pregnancy.
• Health promotion interventions should provide the information, support and opportunities to enhance personal and social skills, to enable people to exercise control over, and improve, their sexual health.
• There should be a range of general measures to improve detection of sexual health needs, including providing open access to appropriate health professionals in primary, community and secondary care, and specific measures, including screening for chlamydia.
• Shared decision-making between professionals and service users can result in better health outcomes.
• Services should ensure action to encourage service uptake, target high-need communities and expand opportunities to identify needs in a range of health settings.
• Sexual health networks should facilitate prompt and equitable access, co-ordination between services, development of integrated care pathways, increased user choice and consistent quality of care.

Document references

1. Recommended standards for sexual health services, Medical Foundation for AIDS & Sexual Health (2005)

Internet and further reading

• Medical Foundation for AIDS & Sexual Health
• Faculty of Sexual and Reproductive Healthcare
• Sexual Health and HIV, Dept of Health
• Effective Sexual Health Promotion. A Toolkit for Primary Care Trusts and others working in the field of promoting Good Sexual Health and HIV Prevention, Dept of Health, February 2003
• British Association for Sexual Health and HIV