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Commentary |

A National Strategy to Improve Sexual Health

Andrea Swartzendruber, MPH; Jonathan M. Zenilman, MD
JAMA. 2010;304(9):1005-1006. doi:10.1001/jama.2010.1252.
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Sexual health is an integrated care-delivery and prevention concept that recognizes sexual expression as normative and encompasses preventive and treatment services throughout the life span. However, the United States lacks an integrated approach to sexual health. Public health programs such as sexually transmitted disease (STD)/human immunodeficiency virus (HIV) prevention and family planning are categorically funded and organizationally fragmented, and federal reproductive health programs in the past decade emphasized abstinence. As a result, sexual health indicators are poor. Incidence of HIV has not decreased since the 1990s,1 and rates of STDs, unintended pregnancy, teen pregnancy, and abortion are higher than in many developed countries.2 “Sexual health” does not appear once in the more than 1000 pages of the new health care legislation. Nevertheless, the public is keenly interested in sexual health, as evidenced by the uptake of recent medical advances. For example, there are an estimated 17 million prescriptions for erectile dysfunction annually,3 and 26 million doses of human papillomavirus vaccine have been administered since its licensure in 2006.4

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