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Sexual health—health of the nation
  1. M W Adler
  1. Department of Sexually Transmitted Diseases, Royal Free and University College Medical School, The Mortimer Market Centre, off Capper Street, London WC1E 6AU, UK;

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    A decade later—a further failure

    The Health of the Nation: a strategy for health in England (HoN), published in 1992, identified HIV/AIDS and sexual health as one of five priority areas with specific objectives and/or targets being set.1 The incidence of HIV infection was to be reduced with no targets set, however, with a specific target to reduce the incidence of gonorrhoea among men and women aged 15–64 years by at least 20% by 1995 (from 61 new cases per 100 000 of the population to less than 49), and to reduce the rate of conceptions among females under 16 by at least 50% by the year 2000 (from 9.5 per 1000 among 13–15 year olds to no more than 4.8). Five years on from the publication of HoN, it was pointed out that even though the gonorrhoea target had been achieved, most other sexually transmitted infections had increased since publication.2 Additionally, pregnancy rates had not decreased. By 2002, a full decade after HoN, little improvement has occurred, and in most instances, if anything, the nation’s sexual health has declined.


    By 1997 the target of 49 new cases of gonorrhoea per 100 000 had been achieved. However, latest figures indicate an increase in both male and female cases of gonorrhoea in England between 1997 and 2001.3 There was a 84% increase in the number of cases in men from 8418 to 15 475, and in females of 67% from 3981 to 6641, with an overall increase for both sexes of 78% (fig 1). This represents an increase in the rate per 100 000 for both sexes of 76% (from 25 in 1997 to 44 in 2001). The incidence of gonorrhoea has increased in homosexual men, as have other STIs, and this is particularly marked in London. In …

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