Surveys on sexual health: recent developments and future directions

Abstract

The increasingly widespread adoption of the term sexual health reflects a move away from the medicalisation of this specialty. The focus has shifted from clinical practice to lifestyle and behaviour; from clinician to client, and from treatment to prevention. This article discusses these themes, identifying their implications for sexual health research. Recent times have seen, for example, a growing number of studies combining biological and behavioural measures conducted by interdisciplinary teams able to combine biomedical measurements of morbidity with insights into the subjective interpretations of symptoms and consequences. Considerable progress has been made, too, in mounting community based studies, and much has been achieved in gaining compliance and refining sampling methods. Integrated sexual health services, encompassing more than contraceptive or prophylactic service provision, have provided the impetus to investigation of the costs and benefits of coordinated family planning and genitourinary medicine services. Despite its broader focus, there remain opportunities for sexual health research to expand its remit. Studies to date may have focused too narrowly on pathological, to the neglect of health enhancing, consequences of sexual behaviour. (Sex Transm Inf 2001;77:238-241) Keywords: surveys; sexual health Though there is much overlap, sexual health surveys may be distinguished from sexual behaviour surveys (reviewed by Fenton and colleagues 1 ) by the diVerence in key outcome variables: health versus behaviour. The increasing currency of the term sexual health reflects a determined shift in public health thinking. The concept contains clues to recent trends that have implications for research in this area. It marks a move away from the medicalisation of the speciality. Formerly, labels attached to this area of public health practice-sexually transmitted disease or venereal disease-carried connotations of disease and pathology. Traditional settings in which sexual health medicine was practised tended to focus on the disease category (for example, venereal disease clinic), somatic site (genitourinary clinic), or else were so euphemistically identified (as in "special clinic") as to suggest something morally questionable. The term sexual health lifts the specialty out of the clinical domain, focusing on lifestyle and behaviour rather than clinical practice, shifting the balance to patient rather than practitioner, and to prevention rather than treatment.The concept of sexual health encapsulates another recent development-to treat health related aspects of sexual behaviour holistically. Instead of controlling infection in one clinical setting and unwanted conception in another, the modern sexual health service increasingly oVers "one stop shopping" in an integrated setting.These trends are mirrored in research into this area. Empirical work is increasingly behaviourally rather than clinically focused, concerned with prevention as well as treatment, involving interdisciplinary teams of clinicians and...

Early onset of sexual intercourse is an indicator for hazardous lifestyle and problematic life situation

“…Furthermore, according to an American survey (14), most teenager (65% of girls and 57% of boys) who have had sex say they wish they had waited. However, associations between early sexual initiation and health outcomes and other lifestyle behaviours are rarely investigated in Sweden: this might be a global issue, as Welling (15) considers research within the field of sexual health must be improved and not neglect health enhancing aspects.…”

Research on sexuality: achievements and prospects

“…Sexuality has also been fundamentally associated with disease -in spite of constant efforts of many researchers and professionals to loosen this link and to reorient thinking towards the concept of sexual health in the sense of "the integration of the physical, emotional and intellectual and social aspects of sexual being in ways that are enriching and that enhance personality, communication and love", as defined by WHO in 1975. This "new" paradigm of sexual health is still scarcely visible in epidemiological and social research (Wellings & Cleland 2001), particularly in population surveys. Certainly, from the point of view of prevention of ill health, but less so from the point of view sexual health promotion.…”

“…Certainly, from the point of view of prevention of ill health, but less so from the point of view sexual health promotion. This "new" paradigm of sexual health is still scarcely visible in epidemiological and social research (Wellings & Cleland 2001), particularly in population surveys. The slowness in the reorientation of sexual health education in Switzerland in this direction is an example (Spencer et al 2001).…”

“…Many countries, especially in Africa, Europe, and North America, conducted large population surveys; either comprehensive and complex surveys on sexuality such as in France (Spira et al 1993) and the United Kingdom (Johnson et al 2001), or simple KABP studies. This "new" paradigm of sexual health is still scarcely visible in epidemiological and social research (Wellings & Cleland 2001), particularly in population surveys. Over and above the surveys themselves, it is the conditions under which they were conducted which is of particular interest: large multidisciplinary teams were set up, often multicentred, associating researchers from many social science disciplines, epidemiologists and clinicians.…”

Speakeasy: a UK-wide initiative raising parents' confidence and ability to talk about sex and relationships with their children

“…More specifically, there is also strong evidence of a positive association between parent -child communication around sex and relationships and enhanced sexual health outcomes for children (Kirby 2008), including the reduction of teenage pregnancy and sexually transmitted infections (STIs) (Wellings and Cleland 2001). Parent -child communication around a range of sexual matters is associated with a recognition and respect for children's sexual identity and self-esteem.…”