Background The first formal U.S. government recognition of the importance of a sexual health framework for enhancing STD/HIV prevention—The Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behaviour –was published in 2001. Since then, many measures of adverse health outcomes of sexual behaviour have improved only minimally or worsened, including HIV, STD, and teen pregnancy. CDC is committed to enhancing program impact for STD/HIV prevention and other programs by complementing traditional prevention efforts with a health promotion framework that comprehensively addresses the broader issue of sexual health.

Methods We have developed a cross-CDC Sexual Health Steering Committee including Divisions of STD Prevention, HIV/AIDS Prevention, Viral Hepatitis, Adolescent/School Health, Reproductive Health, and Violence Prevention which works collaboratively with a Sexual Health Workgroup of the CDC/HRSA Advisory Committee on HIV and STD.

Results Key objectives of the CDC sexual health effort include increased knowledge and awareness of and healthy/respectful attitudes regarding sexual health; increased use of high-quality, coordinated and integrated educational, programmatic, and clinical services; increased healthy, responsible, and respectful sexual behaviours; improved healthy and respectful sexual relationships, free of coercion; and decreased adverse health outcomes, including HIV/STD, viral hepatitis, unplanned pregnancy, and sexual and intimate partner violence. Initial efforts focused on a policy discussion paper and expert consultation on “A Public Health Approach for Advancing Sexual Health in the USA” Subsequent steps have included expanding engagement of stakeholders from a broad range of perspectives; steps to evaluate a sexual health communication framework; an expanded CDC sexual health website; efforts to incorporate sexual health into key U.S. policy documents (eg, National HIV AIDS Strategy, Healthy People 2020 key indicators; National Prevention Strategy); planning a national coalition to address sexual health in the general population, adolescents/young adults, and among MSM; and development of a conceptual framework, logic model, and CDC definition of sexual health to inform a final white paper on sexual health.

Conclusions Developing and implementing a sexual health framework in a society with diverse values is challenging, but core public health prevention efforts must be enhanced by a renewed effort to address issues of sexual health and responsible sexual behaviour as an intrinsic part of human health. The use of a sexual health framework has great potential for improving public health outcomes by providing messages that are more effective at reaching the public and providers, enhancing the efficiency and effectiveness of services, and facilitating societal dialogue around sexuality and sexual behaviour.