It is important to be aware of the pitfalls as well as the possible gains to be made in embracing the terminology of sexual health promotion instead of HIV prevention. Here are some suggestions:

Disadvantages

• Without vigilance, integration of HIV–related activity could mean that specific reference to HIV disappears.
• HIV workers are disempowered and cannot enter generic posts.
• The politicisation brought by HIV workers to health promotion could be marginalised.
• Sexual health could be controlled by medical specialists and reinforce a narrow disease prevention approach.
• It may focus only on one or two aspects of sex (e.g. contraception, STIs) and restrict sexual health work to single issues rather than a holistic approach.

Advantages

• It is person–centred, focusing on expressed needs and on how people live their sex lives.
• It can be used to justify a reorientation of HIV–related strategies which are based on a wider approach to health promotion (e.g. community development).
• It can be used to take a more positive approach to HIV–related health promotion (i.e. not just disease prevention).
• It can be used to support a positive view of sex.
• It can be used to promote a more positive view of sexual diversity (including mental health).
• As a Health of the Nation issue, incorporation into wider health promotion programmes can help to keep HIV a priority.
• It may help to secure funding after HIV–specific funds are withdrawn
• It can enable workers to access professional development to support their wider role.

These lists are not meant to be exhaustive; it would be interesting and perhaps more useful for individual HIV workers to discuss the relevance of these issues for their own work. Ultimately, it may be only through actively planning how best to manage the change to sexual health promotion that HIV prevention work appropriate to the next ten years will find a place.

References

Curtis H (ed.): Promoting Sexual Health, 1992, BMA/HEA.

Department of Health: The Health of the Nation, June 1991, HMSO.

Department of Health: HIV/AIDS and Sexual Health: the Health of the Nation Key Area Handbook, 1992, HMSO.

French P & George V: Developing a Sexual Health Promotion Strategy in the GUM Service, January 1994, Camden & Islington Community Health Services NHS Trust.

Gordon P: A Guide to Rapid Organisational Needs Assessment, 1994, International Planned Parenthood Federation.

Sheffield Health Authority & Sheffield Family Health Services Authority: Promoting Sexual Health & Well–Being in Sheffield: a Strategy for Improving Sexual Health, December 1993, SHA/SFHSA.