As a response to the continuing epidemic of sexually transmitted infections and the high teenage pregnancy rate in England and Wales the government has delivered White Papers and guidelines to begin to tackle the problem. These include;
• Social Exclusion Unit report on Teenage Pregnancy (Teenage Pregnancy Unit, 1999)
• The National Strategy for Sexual Health and HIV (DH, 2001)
• The National Strategy for Sexual Health and HIV Implementation Action Plan (DH, 2002)
• The National Chlamydia Screening Programme in England (DH, 2004b)
• Choosing Health: Making Healthier Choices Easier Choices (DH, 2004a)
• Recommended Standards for Sexual Health Services (DH, 2005)
The most significant of these was the publication of The National Strategy for Sexual Health and HIV (DH, 2001). This was the first of the major policy documents to concentrate solely on the provision and modernisation of sexual health services. It was also unique in that it examined the related problems of HIV and Sexually Transmitted Infections in the same policy document. The main aims of the strategy are to:
• Reduce the incidence of HIV and STIs;
• Reduce the prevalence of undiagnosed HIV and STIs;
• Reduce unintended pregnancy rates;
• Improve health and social care of people living with HIV; and
• Reduce the stigma associated with HIV and STIs.
It is clear from the strategy document that the approach was one that viewed sexual health as an intergral part of public health and acknowledged that 'sexual health' inequalities exist between different social groups and cultures. The Government proposed that these aims would be met through the following actions:
• The setting of a new target for a 25 per cent reduction of newly acquired HIV and gonorrhoea infections by the end of 2007 (DH, 2001)
• The provision of clear information about sexual health so that people can make informed decisions about preventing STIs and HIV
• Ensuring the provision of a sound evidence base for effective HIV/STI prevention
• The development of managed networks for HIV and sexual health services, leading to a more integrated sexual health service.
Alongside the recommendations of the sexual health strategy the Teenage Pregnancy report (Social Exclusion Unit 1999) made recommendations specific to teen pregnancy, including the aim to halve teenage conceptions among under 18s by 2010.
The Sexual Health Strategy, along with the Teenage Pregnancy report, has been welcomed as an important step in tackling sexual health and integrating sexual health services in England. However, critics are disappointed that it does not go far enough - in particular that the policy was not given the status of a National Service Framework (Alder, 2003; Duffin, 2005).
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