The Role Of The Health Professional Promoting Sexual Health

Healthcare professionals are vital to the achievement of government sexual health strategies and the improvement of the overall sexual health of the population. For many health professionals the key way in which they can respond to help to achieve Government targets in reducing the prevalence of sexually transmitted infections or reduce unwanted pregnancy is through their health promotion work. Both the Teenage Pregnancy report (Social Exclusion Unit, 1999) and the National Strategy for Sexual Health (DH, 2001) clearly identify ignorance as being a key factor, with people lacking the information they need to make informed choices that will affect their sexual health (Cooper, 2001). This is an area in which the health promotion skills of health and social care professionals are key to providing accurate, individually tailored information; though as we will see, sexual health promotion is a much more complex business than just providing information.

In order that Government targets are achieved and to move towards a more universal goal of good sexual health for everyone, all health and social care professionals need to respond to the opportunities presented to them to promote the sexual health of their clients and patients. This includes generic professionals such as GPs, practice nurses, teachers and youth workers, as well as dedicated sexual health professionals.

The preceding discussion has highlighted the broad objectives of health promotion in the context of public health, and it can be seen that there are many possible approaches to health-promotion work. The health-promotion approach chosen by practitioners will be dependent on the aims of their health-promotion activity. Ewles and Simnett (2003) suggest that health promoters need to clarify two main health-promotion aims before starting:

• Whether the aim is to change the individual or to change society

The choice here is between a traditional approach to health education, which aims to change the behaviour of individuals to induce them to adopt a healthier lifestyle, or a more radical health-promotion approach, which seeks to make the environment and society a healthier place in which to live - to change the structure of society. In other words, professionals need to ask themselves whether the scope of their work is to be focused on individuals (for example, persuading an individual to adopt safer sexual practices) or to be involved in more radical approaches such as campaigning for sexual health-promotion campaigns to be shown on children's television or attempting to change societal attitudes towards gays.

• Whether the aim is for compliance or informed choice

Here health promoters need to decide what it is they want to achieve - compliance or informed choice. Professionals need to ask themselves whether the aim of their health-promotion activity is to ensure that the public or a client complies with a health initiative or programme through the use of education, or through media publicity or through persuasion. Or is their aim to create circumstances in which the client or the public are enabled to make informed choices? If so, do their clients have the skills and ability to enact those choices? Many health professionals will say they want to allow clients to make informed choices, but in reality feel uncomfortable when a client chooses the option (or lifestyle behaviour) that is regarded as not being healthy (for example continuing to have unprotected sex)! This is an important dimension, which it is important for all professionals to explore with themselves before embarking on health-promotion work.

It is essential, then, that all professionals working in the sexual health field have a holistic understanding of sexual health and a non-judgemental approach in dealing with clients and patients. Alison Duffin, writing about the role of the nurse in sexual health, argues that nurses need a: '... holistic approach to sexual health which encompasses health promotion advice, recognizes varying sexual health behavior, understands that sexually acquired infection can interfere with sexual function, and most importantly accepts that psychological factors impair and inhibit sexual functioning and relationships' (Duffin, 2005, p. 417).

Specifically, Ingram Fogel (1990) argues that sexual health promoters need the following skills:

• an accurate knowledge base;

• self-awareness of their own personal value system and self-acceptance as a sexual being; and

• the ability to communicate genuinely and therapeutically with clients.

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