Rethinking sexual health clinics

摘要

HIV, AIDS, and sexual health make up one of five key areas identified in the Health of the Nation. The objectives for this area are to reduce the incidence of HIV infection and other sexually transmitted diseases and the number of unwanted pregnancies. Sexual health has been defined by Greenhouse as, "the enjoyment of sexual activity of one's choice without suffering or causing physical or mental harm. In Britain, as in many other countries, the provision of sexual health care has often been fragmented and isolated and has sometimes been incomplete, being split among family planning, general practice, genitourinary medicine, and gynaecology. The cause of this fragmentation is that sexual health covers many different areas, including contraception, sexually transmitted diseases, infertility, termination of pregnancy, menopausal symptoms, and psychosexual difficulties. Consequently men and women present to many different specialties according to their problem. A woman presenting to her family planning doctor or general practitioner with a vaginal discharge may be screened for vaginal infections but not always for cervical infections if facilities are limited. If a sexually transmitted infection such as genital warts is detected, and treatment given, facilities may not exist to screen for other sexually transmitted infections, and family planning clinics and general practices are unlikely to have the resources for tracing contacts.