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Some consultations make you think. Not infrequently in the sexual health clinic we see patients with recurrent genital herpes (herpes simplex virus (HSV)) or protracted anogenital human papilloma virus (HPV) infections who declare that their sexual lives are at an end or at least on indefinite hold. The emotional impact for such individuals is often devastating. In a culture that is risk averse, uncomfortable with the vagaries of chance, people still commonly blame those who pass on STIs. While many cope well emotionally, some carriers will choose celibacy rather than risk being a further link in this chain. It is possible that many more patients than we realise opt for sexual exile rather than be exposed to such moral censure. Compassion may move clinicians to challenge this decision. But should we? And how does one do so when to argue for any reduction in their sexual restraint is surely an argument for greater risk-taking with the health of others and a higher chance of ensuing harm?
In sexual health, we get used to telling people not to have sex. In fact, we get so used to it that we fail to notice the moral audacity, the scale of the presumption involved. Of course, we reassure ourselves that we do so because of our commitment to public health. Unlike most medical practitioners, we are charged not simply with the care of our patients but with an explicit concern for the protection of others who may be harmed through the passage of STD. The WHO has stated that “sexual rights protect all …