Sexual and Reproductive Health

 Sexual and Reproductive health continues to evolve as a multi-faceted field of health. The World Health Organization started its work in this field in 1974. The latest overview articulates, "Sexual health, when viewed affirmatively, requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence" (World Health Organization). This overview adequately addresses both sexual and reproductive health and the abilities and factors by which folks are able to achieve sexual health and well-being. 

Sexual and Reproductive health (SRH) has long been a global issue, the WHO began their work over half a century ago. In 2004, they presented a strategy outlining five priority aspects of care, as sexual and reproductive ill-health were responsible for 20% of the global burden for women and 14% for men. However, concerns with sexual health have gone back further, following the first Population Conference in Rome in 1954. These were focused on population control and growth, with the result of outright force used to bring down the population growth. This resulted in human rights being associated with population control in 1968 at Teheran's International Conference on Human Rights. 

Sexual and Reproductive health awareness is vital now more than ever because it is a complex public health challenge. Scholars from the University of Birmingham, UK, and Maastricht University, The Netherlands launched a qualitative study with experts in Organisation for Economic Co-operation and Development (OECD) member countries. The objectives of the study were to explore the intersectoral costs and benefits associated with sexual health issues and interventions, categorize them, and develop a framework to better understand them and guide future research. The study concluded that sexual health is complex and has many impacts, which are demonstrated by the image to the left: 

Sexual and Reproductive health is not only a global issue, but an issue that doesn’t only involve health. If folks are not able to access sexual health education and services due to stigma or lack of awareness/accessibility it presents a larger problem. Youth are among the most vulnerable populations and experience the highest rates of sexually transmitted infections (STIs). Bednarczyk, Orogun, Perna, et al. ( 2024), investigates the relationship between the experience of sexual health education and sexual health outcomes. This survey was based in the UK, with 5,457 respondents. 90% of respondents received formal sex education, and 12% felt that it had a positive, lasting effect on their sex life. Reproductive biology, pregnancy, safe sex, and avoiding STIs were taught all across, however, 13% of the time respondents learned about different sexualities, pleasure, and gender identity.  A majority felt they had a decent understanding of sexual health risks; safe sex was consistently practiced by 43% and regular testing was practiced by 25%. While these might look like arbitrary numbers, comprehensive sex education ensures that the population of sexually active individuals are informed of the steps they should take to maintain their health, how to communicate with partners, and how to research the resources that are provided in their vicinity.

Sexual and reproductive health is an area that can be sensitive to many, many cultures and societies view sex as "taboo," which exemplifies the importance of not viewing sexual and reproductive health as a "health-only" term. With the multi-faceted nature of SRH, it is important to be aware of the different impacts that SRH has in various facets of life. Figure 1 demonstrates this in the first theme, “Interconnections to other areas of health,” which is one of the six identified impacts that affect the holistic nature of sexual health. Going beyond the figure, more factors influence this impact. This ties into sociology, focusing on how people in different generations, and cultures, and how social change have influenced how one navigates the topic of sexual and reproductive health.

 To address sexual health and increase accessibility, one of the first steps towards decreasing stigma is to provide comprehensive education, which makes one reflect and change perceptions of what sexual and reproductive health encompasses. The most important step is the realization that sex is pleasurable and is something that should be talked about. Through education, increased awareness surrounding consent and communication positively impacts sexual health. Conversations will continue to evolve and be had, which is why comprehensive sex education is needed, and should be mandated in school curriculum. Sexual and Reproductive health requires a positive outlook to create change. There have been many great strides in SRH. With increased education and outreach efforts, maternal mortality rates have dropped around the world, contraception is more readily available, and HIV is no longer a death sentence, with the introduction of anti-retroviral therapy. With these continuing advancements, an additional step is making sure folks are living in safe environments that promote sexual health. 

References

Bednarczyk, E., Orogun, L., Perna, A., & Edokpayi, K. (2024). (085) Investigating The Relationship Between Experiences of Sexual Health Education and Sexual Health Outcomes. The Journal of Sexual  Medicine, 21 (Supplement_2). https://doi.org/10.1093/jsxmed/qdae002.077  

Dr. Liji Thomas, M. (2023, January 17). History of sexual health. News. https://www.news-medical.net/health/History-of-Sexual-Health.aspx  

Schnitzler, L., Paulus, A. T., Roberts, T. E., Evers, S. M., & Jackson, L. J. (2023). Exploring the wider societal impacts of sexual health issues and interventions to build a framework for research and policy: A qualitative study based on in-depth semi-structured interviews with experts in OECD member countries. BMJ Open, 13(1). https://doi.org/10.1136/bmjopen-2022-066663 

World Health Organization. Sexual health. World Health Organization. https://www.who.int/healthtopics/sexual-health#tab=tab_1