As the first nationally co-ordinated approach to improving the sexual health and wellbeing of the population, the publication of a national sexual health strategy is an important milestone. Defined by the World Health Organisation (WHO) as a state of physical, emotional, mental and social wellbeing in relation to sexuality, sexual health is not merely the absence of disease or dysfunction but "requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence".
Launching the strategy, Minister for Health Leo Varadkar said he wanted to remove any stigma around sexual health, promoting a more mature, open attitude to sexual wellbeing. He noted a recent increase in sexually transmitted infections (STIs) in the Republic: notification of STIs rose from 3,361 cases in 1995 to 12,753 in 2013. Provisional figures suggest a rise in HIV diagnoses in 2015, and a marked increase in cases of antibiotic-resistant gonorrhoea since 2010.
However there is more to sexual health than simply avoiding infection. Embarrassment and a lack of knowledge contribute to crisis pregnancies, poor health outcomes, stigma and discrimination. Among the strategy’s stated goals is to raise awareness of sexual health issues and to improve education in the area in order to facilitate people making better decisions about their sexual health. In this regard a specific commitment to train teachers and youth workers in the promotion of sexual health is welcome.
Although the strategy runs from now until 2020 it identifies a number of goals to be implemented by the end of 2016. Among these is the designation of a national reference laboratory for STIs, consideration of extending the provision of HPV vaccination to adolescent boys, as well as setting up a national sexual health training programme under the HSE. Regrettably there was no clear allocation of funding for the strategy, something the Minister must address to give full credibility to this health policy “first”.