National Strategy for Sexual Health and HIV

The UK Department of Health�s National Strategy for Sexual Health and HIV has now been published as a consultation document. The strategy appears on the backdrop of rising rates of STI, HIV, unintended pregnancies, and attendance at clinics for sexually transmitted infections in the UK, and indeed globally. It aims to increase awareness of sexual health issues not only among the general public, but also health care providers. This is to be done by widening the net for STI screening and infection testing.

The strategy proposes a three tier system of service provision. Primary care and user-friendly outreach centres are to interlink and supplement existing specialist STI services. Chlamydia screening is to be offered to young women (though not men) and HIV testing is to be extended to all antenatal and STI clinic attenders. Comprehensive sexual health is to be offered in one-stop shops initially as a pilot scheme including testing for STI, contraception and sexual health promotion. HIV is to be managed in clinical service networks to allow interchange of accumulated experience. A national campaign to raise awareness of sexual health issues is to begin next year. Ambitious targets are set � though with woefully inadequate funding.

Sexually Transmitted Infections has been in the forefront of research not merely in the pathogenesis, epidemiology and treatment of STIs but also in innovative ways of modifying behaviour and providing services relating to sexual health. Moreover, as a journal with an international audience, we are uniquely based to allow interchange of ideas across borders. The success, and more often failure, of behaviour interventions highlight the difficulties faced in this field. On the backdrop of a global epidemic of STI and HIV we are now witnessing a resurgence of risky behaviour in the young in advanced industrial countries. There are using novel ways of making links � such as internet chat rooms. Near-extinct infections such as syphilis are on the rise.

The Department of Health�s National Strategy for sexual health and HIV is up for consultation till December 2001. We invite readers and all others interested in issues of sexual health to write in their comments on this document, using the eLetters feature in the box to the right of this page. We particularly ask those in other countries to enrich this document with their own experience. Comments will be available on the web site. Selected commentary may be published in the paper journal.

For further information, see the editorial in the BMJ, published 4th August 2001.

Mohsen Shahmanesh