The World Health Organization defines sexual health as “a state of physical, emotional, mental, and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health 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, and discrimination.”[1]

For many local health departments, programs that address sexual health are typically organized by disease or topic area and are often siloed, in large part due to the categorical nature of funding. As opposed to a disease-specific approach, applying a sexual health framework looks at the context in which unwanted health outcomes occur and addresses sexuality as an inextricable element of health. Although disease prevention and control remain a central focus, other factors influencing health outcomes are addressed at the individual, relationship, community, and society levels. Employing a sexual health framework has the potential to greatly improve existing public health disease prevention and control programs.[2][3]

Recognizing the value of a sexual health framework approach, NACCHO staff attended the 2015 National Sexual Health Conference in Keystone, Colorado to learn more about how such principles can be applied to local public health practice. Conference sessions covered a wide range of important topics, including the social determinants of sexual health, integrating sexual health into clinical care, LGBTQ health, reproductive health, advancements and innovations in STI and HIV prevention and treatment, comprehensive sexuality education, the intersection of sexual health with mental health and substance abuse, sexual violence prevention, and sexual health across the lifespan. The meeting was filled with celebration for how far the field has come and excitement about new opportunities for advancing this progress. However, we were also reminded that more work remains to be done, such as addressing the rising rates of new HIV infections in young MSM of color.

I spoke to John Douglas, conference organizer and Director of Tri-County Health Department in Colorado, after the conference. He stated that “health issues related to sexual behavior are among the most important public health priorities in our communities. As we in local public health increasingly describe our efforts as focused on ‘optimizing health and wellness’ for all of our residents, coordinating related programs under the framework of ‘sexual health’ can enhance program efficiency and impact and also send a powerful message about normalizing sexuality as a key aspect of human health.”

Local health departments play an important role in improving sexual health outcomes and are addressing these issues in a number of meaningful ways. The majority of local health departments conduct surveillance and partner services and over half screen for STIs, including HIV, and provide family planning services.[4] Addressing these programs through a sexual health framework has the potential to make a big impact on health outcomes and NACCHO encourages local health departments to consider what this might look like in practice.

1. World Health Organization. Sexual and Reproductive Health webpage. Retrieved July 15, 2015 from http://www.who.int/reproductivehealth/topics/sexual_health/sh_definitions/en/
2. Douglas, J. (2011, August). Advancing a Public Health Approach to Improve Sexual Health in the United States: A Framework for National Efforts. Presentation for the Implications of a Sexual Health Approach for HIV Prevention National HIV Prevention Conference, Atlanta, GA. Retrieved from http://www.cdc.gov/sexualhealth/docs/DouglasNHPCHIVpx081611last.pdf
3. Satcher, D., Hook, E. & Coleman, E. (2015). Sexual Health in America: Improving Patient Care and Public Health. The Journal of the American Medical Association. Retrieved July 15, 2015 from http://jama.jamanetwork.com/article.aspx?articleid=2338495
4. National Association of County and City Health Officials. (2013). 2013 profile of local health departments. Retrieved July 15, 2015, from http://www.naccho.org/topics/infrastructure/profile/upload/2013-National-Profile-of-Local-Health-Departments-report.pdf