From STD Prevention to Sexual Health, and Back
Editor's Note: This article is part of a series developed by the American Social Health Association (ASHA) in celebration of Sexual Health Month 2012 during September. RHRC will be publishing articles by ASHA all month, see all the articles here and visit ASHA online throughout September for updates.
Cross-posted with permission from the American Social Health Association (ASHA).
One evening, during the week of the 2001 International Society for STD Research meeting in Berlin, I met with a couple of colleagues for beers after the day's proceedings. We lamented the the narrow focus of many conferences was on disease and the lack of a broader sexuality framework. "It is time to put sex into STD prevention," one of my colleagues said. The comment was a bit wistful at the time and I don't think any of us could have foreseen that a decade later our field would be expressing so much more interest in sexuality and sexual health.
This has been accentuated by the Center for Disease Control's (CDC) recent efforts in developing a sexual health framework signalling an overall shift from disease prevention to health promotion. Credit goes to Dr. John Douglas, the Chief Medical Officer in the National Center for HIV, Hepatitis, STD and TB Prevention, who spearheaded this effort in the past three years and has created a broad coalition of stakeholders across the political and cultural spectrum to endorse a national strategy for sexual health.
Of course, the CDC's efforts did not arise in a vacuum and there have been a number of developments in the past decade that have fostered a broad-based discussion of sexual health. For me, one of the heralding events in the sexual health discourse was Dr. Amy Schalet's presentation on teen sexuality at the Jacksonville STD Prevention Conference in 2006. I have always been taken by Dr. Schalet's work -- perhaps because as a chauvinist Dutchman (born and raised in Amsterdam) I liked her findings that a more liberal attitude towards sexuality among Dutch teens and their parents is associated with much lower rates of teen pregnancy and sexually transmitted infections (STIs) in the Netherlands compared to the U.S. Her book: "Not Under My Roof" was published last year (a podcast interview with Dr. Schalet is available at this link).
However, association does not causation make. There is a lot to like about a more positive approach towards sexuality, but a causal link between better sexual health and lower pregnancy and STI rates ultimately requires scientific evidence that goes beyond intuitive reasoning.