Background The United States faces a variety of public health issues related to sexual behaviour including HIV, STD, unintended pregnancy, and sexual violence. A 2010 CDC consultation on A Public Health Approach for Advancing Sexual Health in the United States (http://www.cdc.gov/sexualhealth/docs/SexualHealthReport-2011–508.pdf) provided recommendations on how CDC could enhance prevention programme impact by comprehensively addressing sexual health.

Methods Since the consultation, CDC has worked across its divisions and with external partners to translate the theoretical concept of sexual health into public health action through national leadership, partnership development, and scientific and programme efforts.

Results Initially, we developed a sexual health framework emphasising the importance of using sexual health promotion to complement and enhance core disease control and prevention activities based on five key principles: acknowledgment of the impact of sexual health on overall health, consideration of underlying social issues, an emphasis on wellness, a focus on relationships, and integrated prevention approaches. Subsequently, we reviewed U.S. national data systems to identify existing measures of key domains of sexual health and conducted health communications research assessing optimal frameworks and messages for communicating with audiences with varied perspectives. Partnership development was accelerated by forming a National Sexual Health Coalition, with a spectrum of non-governmental partners addressing sexual health among the general population, adolescents, and MSM. Public health implementation of sexual health promotion has focused on supporting development of sexual health plans by U.S. states and sexual health training for providers in public health and primary care settings.

Conclusions Implementing actions to address sexual health in a society with diverse values is a challenging and evolving process, but has great potential to improve prevention efforts by engaging a spectrum of partners, facilitating societal dialogue around sexuality and sexual behaviour, reducing stigma and fear, and enhancing efficiency and effectiveness of prevention messages and services.