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We are excited to announce the new Michael E. Metz Fellowship in Couples' Sexual Health that will help prepare postdoctoral fellows for a career that will combine clinical and scholarly endeavors in the area of couples' sexual health.

The Metz Fellowship was created with a generous gift from Hildy Bowbeer to honor the life and work of her husband, Michael E. Metz, PhD. Metz was a nationally respected psychologist and couples therapist, who for 12 years served on the faculty of PHS and directed the relationship and sex therapy program. Metz passed away in March 2012.

Bowbeer said, "Mike was not only committed to couples' sexual health in his own clinical and research work, but was also passionate about training the next generation of scholars and therapists in this field. I'm thrilled to be able to help PHS carry on his legacy in this way."

The Metz Fellowship is a two-year program that will follow the training model of our postdoctoral fellowship, but the Metz Fellow will focus her or his clinical work on couples' sexual health. Bowbeer's gift will enable the Metz fellow to dedicate thirty percent of their time to research in the area of couples' sexual health. "This is a great opportunity for a postdoctoral fellow to have more time to focus on research and scholarly work," said Eli Coleman, PhD, director.

As a clinician Metz worked with more than 6,000 couples, addressing and resolving relationship and sexual problems, improving their quality of life. He authored 4 books and more than 60 professional articles and book chapters in the areas of couple intimacy, relationship conflict styles, sexual health, sexual medicine, and cognitive-behavioral features of satisfying relationships. He conceptualized the "Good Enough Sex Model" which was greeted with great appreciation. Throughout his career, Metz received many awards and honors.

Now accepting applications for fall 2013
http://z.umn.edu/metz

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So what does the New Year hold for the future of sexual health? Can we be optimistic? I think so. There are four broad reasons to feel optimistic.

1.  As governments struggle with the complexities of the sexual problems and declining resources to commit to alleviate the myriad of problems, they will have no choice but to create broad strategies to promote sexual health. We have a public health imperative. We have an opportunity to use an evidence-based approach to public policy. Public health policies recognize that there is no choice but to address the barriers and opportunities for all citizens to enjoy the right to sexual health. They also recognize more and more that sexual health is a function of the recognition of basic human rights for all citizens.

2.  Sexual Health has taken root in public health policy and sexual science will be needed to guide it. Now is the time of a unique opportunity in history of which we must take advantage.

3.  The field of sexology has clearly established itself as a key player in the effort to promote a healthier society in the new millennium. The HIV pandemic alone continues to drive home the need to understand human sexuality in its full complexity--from the interdisciplinary perspective of sexology. Now sexologists are being asked to come to the table and help direct public policy by sharing our knowledge, research, and expertise.

4.  Public health officials recognize more than any other time that comprehensive sexuality education is essential. They need to support sexuality research and we see a flourishing of funding that is rooted in sound theory and scientific methodology. We see an increase in research publications which add to our knowledge and legitimacy of our scientific field.

In the United States, we have seen major developments that are guiding lights for the future of sexual health. There have been 5 major developments which will have a major impact in the coming year.

1.  In 2010, the Centers for Disease Control and Prevention (CDC) held a sexual health consultation to develop a broad consensus of how we could develop a strong, comprehensive, broad and integrated approach to sexual health. The meeting report was published in 2011. After another year of further consultation, the CDC is about to publish a white paper outlining the basic and fundamental strategies for the coming decades. The CDC adopted its own sexual health definition that could guide its work in this area.

2.  In 2010, the office of the President of the United States published a National HIV Strategy - the first comprehensive national strategy since the beginning of the epidemic! In this strategy, there was a strong statement that we must move away from thinking that one approach to HIV prevention will work, whether it is condoms, pills, information or prevention programs. Instead, we need to develop, evaluate, and implement effective comprehensive prevention strategies and combination therapies. While obvious, it was stated clearly that all Americans should have access to a shared base of factual information about HIV - a revival of the basic premise that US Surgeon General Koop stood upon in disseminating frank and scientifically accurate information to all households in the mid-1980s. Finally, this new strategy outlined a public health approach to sexual health that includes HIV prevention as one component. This was the first time the term sexual health was used in public policy in the United States. The President and Secretary of State Hillary Clinton have called for a concerted approach to creating an AIDS-free generation.

3.  In 2011, the office of the US Surgeon General released a report that was developed by the National Prevention Council. This report was the first national strategy on prevention that called for us to work together to improve health and quality of life by moving from a focus on sickness and disease to one based on prevention and wellness. Reproductive and sexual health is one of the seven targeted priorities. Many of these recommendations have been incorporated and will be funded by the Affordable Care Act.

4.  In 2011, a report commissioned by the Secretary of Health and Human Services and conducted by the Institute of Medicine, was released on the health of gay, lesbian, and transgendered individuals. This report called upon more understanding and research on these marginalized populations and outlined a broad strategy to promote the health and wellbeing of these American citizens. This report has already had profound positive impact on public policies and public attitudes.

5.  In 2011, the Department of Health and Human Services set broad health goals for the coming decade entitled --Healthy People 2020. In this broad health strategy "Reproductive and Sexual Health" was clearly identified as a leading health indicator. The outcomes of the recent national elections have ensured that these broad strategies to promote sexual health will go forward with commitment, leadership, and essential funding.

So, I think we can look forward to 2013 with a sense of optimism. We cannot be complacent, but we can ride this wave of renewed commitment to the promotion of sexual health for all Americans.

The Program in Human Sexuality will do its part - but it will be made easier by this social and political climate that shares our ideals of creating a sexually healthier climate and overcoming barriers to sexual health.

Thank you all for your support of the Program's activities and we wish you the very best in the coming year!

Eli Coleman, PhD
Director and Professor
Chair in Sexual Health

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A recent summit hosted by PHS gathered key medical school educators and sexual health experts to discuss the challenges and opportunities for ensuring physicians are properly trained to address the sexual health needs of their patients.

Participants included former US Surgeons General Joycelyn Elders, MD, and David Satcher, MD, PhD, as well as representatives from the Centers for Disease Control and Prevention, the American Medical Association, the Association of American Medical Colleges, the American Medical Student Organization, and a wide range of medical schools, universities, and organizations. The summit's premise was based upon a series of recently published papers, covering the state of sexual health education in the US and Canada and recommended curriculum changes. Invited speakers shared their perspectives in a think-tank format culminating in a working group session. A meeting report will be prepared and shared with interested parties and key stakeholders.

Eli Coleman, PhD, the event organizer said, "It is our hope that this summit and meeting report will serve as a catalyst for re-invigorating the necessary sexual health curriculum to meet the needs of physicians of the future."

During the summit participants heard from educators, students, and researchers, including many of the authors whose articles were used for background. Educators from a range of medical schools shared information about their sexual health curricula and training programs. On Tuesday morning participants gathered into work groups around the topics of curriculum placement, evaluation, faculty development, inter-professional education and training for integrated care, and cooperative strategies and partnerships.

The event was held on December 3 - 4, 2012, at the Commons Hotel in Minneapolis, Minnesota. The event was made possible through funds from the Joycelyn Elders Chair in Sexual Health Education and the University of Minnesota Medical School through support of a Herz Grant and the Office of Minority Affairs and Diversity.

PHOTO: summit participants; credit Duane Rost

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I am writing this letter from the XIX International AIDS Conference in Washington, D.C. It has been 22 years since the International AIDS conference was held in the United States (mainly due to the unwillingness on the part of the United States to grant visas for HIV-infected individuals- only recently lifted).

Here 25,000 scientists, policy makers, health and education ministry officials, advocates, and activists from around the world are gathered with a renewed determination to stem the tide of this epidemic. Medical advances, improved access to care, prevention initiatives, and our nation's revived determination are all good signs, but as a culture we will need to shift our perspective to stop the spread of HIV.

Recent news of pre-exposure and post-exposure prophylaxis treatment has been encouraging. Last week, the Food and Drug Administration (FDA) approved Truvada (emtricitabine and tenofovir disoproxil fumarate) for Pre-Exposure Prophylaxis (PrEP) to prevent the spread of HIV to high-risk, healthy individuals. Other similar preparations are under investigation and HIV therapeutic drugs are being developed for prophylactic use. These drugs are very costly and require individuals to adhere to rigid compliance in order to be effective.

Also, last week, Health and Human Services (HHS) Secretary Kathleen Sebelius announced nearly $80 million in grants to increase access to HIV/AIDS care across the United States. The funding will ensure that low-income people living with HIV/AIDS continue to have access to life-saving health care and medications. This effort stemmed from President Obama's determination to create an AIDS-free generation.

In addition, there is reduced stigma for HIV infected individuals. The CDC just launched "Let's Stop HIV Together" a new campaign that is part of the 5-year initiative started in 2009 to reduce stigma around HIV and advocate for more access to testing and treatment "Act Against AIDS."

The United States, through its National AIDS Strategy, has outlined a "prevention" strategy through early detection and early treatment, focusing on vulnerable populations.

These new strategies are overdue. In the United States, we continue to experience 50,000 new infections a year. And, there are serious health disparities. People of color, youth, and sexual minorities are much more likely to become infected than other groups.

Over the last 30 years, where have we failed? We know that HIV is still mostly spread by sexual behavior. Yet, the disease is rather easily preventable through the use of condoms. Condoms are reasonably inexpensive, potentially readily available, easy to use, and highly effective in preventing HIV and other sexually transmitted infections (and unintended pregnancy). What a bargain! So, why are they not used more?

Behavioral HIV prevention strategies and interventions have tried to get people to reduce risky sexual behavior and promote condom use. While reasonably effective, there needs to be continuous implementation of these interventions, and they are costly. Investment in prevention strategies has always been difficult. With the recently adopted National Prevention Strategy, National AIDS Strategy, and the Affordable Care Act, there is new hope that these investments will be made.

But a fundamental problem remains. We remain a sexually dysfunctional culture. We live in a culture that is still uncomfortable talking about sex and sexuality in a mature and honest fashion. We continue to debate and hold back on providing comprehensive sexuality education. It is very clear that what distinguishes the United States from other developed countries in sexual health indicators is the existence of (or lack thereof) early and sustained comprehensive sexuality education. When kids are educated early they grow up to be more comfortable with talking about sexuality, more likely to be sexually responsible, and have lower rates of sexually transmitted infections and unintended pregnancies. They contribute to a cultural climate that is sexually healthy. That climate then insists on comprehensive sexuality education and thereby creates a cycle of healthiness. In the United States, we are still caught up in a negative and unhealthy vicious cycle. The goal of the Joycelyn Elders Chair in Sexual Health Education is to reverse this negative cycle.

Both Walter Bockting and I, along with over 600 delegates from around the world attended the "Global Forum on Men who Have Sex with Men (MSM) and HIV" as part of the International AIDS Conference. While 60% of new infections around the world are found in gay and bisexual men, only 2% of the global prevention budget is directed at this group. Also, transgender individuals are an overlooked population at major risk for HIV, due in large part to continued stigma and discrimination. This disparity in funding efforts represents the institutionalized stigmatization, heterosexism, and homophobia that exist in our cultures as well as in our public health systems. If we do not attend to this population as well as other marginalized populations such as sex workers and drug users, we will fail in our efforts to stop the spread of infections.

Walter Bockting and I also attended two important meetings pertaining to transgender health and HIV. The first was called "The Great TRANSformation: Towards a Holistic Approach for Healthier and Happier Trans Communities in Latin America and the Caribbean." Walter Bockting talked about "Avenues for Action for the Provision of Care and the Promotion of Well-Being." This symposium represented some of our ongoing work with the Pan American Health Organization in developing and finalizing a "Blueprint for the Provision of Prevention and Care for Transgender Individuals through Latin American and the Caribbean." We also participated in a second special session on "Addressing Stigma in Transgender & Other HIV-Vulnerable Communities" sponsored by the Human Rights Campaign, the International Association of Physicians in AIDS Care, the International Treatment Preparedness Coalition, and the Pan American Health Organization.
 
As the current Chair in Sexual Health, I was happy to participate in this conference and push a sexual health agenda in HIV prevention. I was very pleased that the Program in Human Sexuality was a co-sponsor along with the Pan American Health Organization and the Centers for Disease Control and Prevention of a satellite session on "Addressing Sexual Health and Evidence-based Sexual Health Education: Evolving Opportunities." I spoke on "Towards a Broader Vision of Sexual Health in the New Millennium." I emphasized the need for a broad sexual health approach to stem the tide of the HIV epidemic, which emphasizes a positive and respectful approach to sexuality and sexual expression throughout the lifespan and that acknowledges sexuality as a basic and fundamental aspect of our humanness and that the pursuit of sexual pleasure is natural and desirable. A broad sexual health approach combats sexual coercion, shame, discrimination, and violence. But a sexual health approach must go beyond venereology and, on an individual level, promote positive sexual identity and esteem, honest communication and trust between partners, the possibility of having pleasurable, fulfilling and satisfying sexual experiences, taking responsibility of the consequences of one's sexual choices and their impact on others, and optimizing reproductive capacity and choice. At the community level, it is achieved through access to developmentally appropriate, comprehensive and scientifically accurate sexuality education, clinical and preventative sexual health services, and respect for individual differences and diversity and a lack of societal prejudice, stigma, and discrimination.

The Chair in Sexual Health will continue to work with our faculty at PHS and with partners around the world to promote a sexually healthier culture - not only to address the sexual problems in the world -- but to advance the opportunity for everyone to lead sexually healthier lives which are pleasurable and satisfying.

Eli Coleman, PhD
Professor and Director
Academic Chair in Sexual Health

PHOTO: Omar Banos (Impacto at AIDS Project Los Angeles), Rafael Mazin (Pan American Health Organization), and Eli Coleman

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"Let's Stop HIV Together" is a new initiative launched by the Center for Disease Control and Prevention (CDC) on July 16, 2012. The campaign is a new phase of Act Against AIDS effort launched in 2009 to fight the complacency about HIV/AIDS in the United States and to reduce the risk of infection for the hardest-hit populations. The new campaign shares personal stories of individuals who are living with HIV and asks you to and your community to "Get the facts. Get tested. Get involved."

Based on 2009 statistics, the CDC estimates that in the United States each year 50,000 individuals become infected with HIV. At the end of 2008, an estimated 1,178,350 persons aged 13 and older were living with HIV infection in the United States. Of those, it is estimated that 20% had undiagnosed HIV infections.

If you are interested in promoting "Let's Stop HIV Together" or contributing your story to the campaign visit their website.

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This year the National Public Health Week theme is A Healthier America Begins Today: Join the Movement, April 2 - 8, 2012. The American Public Health Association (APHA) is encouraging more Americans and their communities to take preventive measures to help improve their lives.

This year, with the recent release of the National Prevention Strategy, APHA hopes to address the issue of prevention and wellness to ensure that all is being done to improve our nation's health. The ultimate goal of the APHA is to make the US the healthiest nation in one generation.

The five focus areas include active living and health eating; alcohol, tobacco, and other drugs; communicable diseases; reproductive and sexual health; and mental and emotional well-being.

The APHA says that every year, chronic diseases such as heart disease, cancer and diabetes are responsible for millions of premature deaths. Americans miss 2.5 billion days of work because of these illnesses, and all of that lost productivity adds up to more than $1 trillion. Injuries, unexpected accidents and violence affect people daily in all aspects of life. Unintentional injuries, such as motor vehicle crashes, poisonings, and burns rank among the top 10 causes of death for people aged 44 and younger.

Catching and preventing these illnesses and incidents before they develop is the key to improving our nation's health. There are so many small steps we can take to begin leading healthier lives; sometimes it just takes a little motivation.

In Minneapolis, the School of Public Health at the University of Minnesota is hosting their 8th Annual National Public Health Week Film Festival.  This year the schedule includes films focusing on sexual health with the event on Friday, April 6, 2012, showing "Orgasm, Inc," and vintage sex education shorts.

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The PHS research project All Gender Health is now recruiting participants to assist in the evaluation of a transgender health promotion program.  This is the culmination of a multi-year project funded by the National Institutes for Health (NIH) to look at the health and well-being of transgender people and their partners.  This is one of the first projects to look at the community as a whole, surveying people across the gender spectrum, and targeting health promotion to those who need it most.  All Gender Health will be enrolling participants through May 24, 2012.

All Gender Health is a web-based research project examining the effectiveness of an online activity-based sexual health intervention.  Previous phases of the All Gender Health project involved qualitative and quantitative data gathered from a national sample of the transgender population as well as the male partners of transgender people, which informed the development of the current and final phase.  This final phase is the evaluation of a website comprised of 22 different topics in 8 different modules developed by community members across the country.  Designed to meet users where they are, www.allgenderhealth.org allows each participant to identify goals around topics such as identity, community, resilience, , dating and relationships, and sexual health negotiation. Users then craft a plan toward those objectives in a simple, individualized way.

Over the past few years, a research team led by Walter Bockting, PhD, has worked closely with software engineers to custom build a research and intervention platform for this project.  Project coordinator, Chris Hoefer, describes the intervention as, "What used to be an all-weekend, two-day seminar with high level presentations and smaller group discussions has now been transformed into an interactive web-based experience that anyone anywhere can visit at their leisure in the comfort of their own home.  You only need access to a computer and the internet and you can draw on the knowledge and experiences of a broad collection of educators, entertainers, physicians, therapists, advocates, and community members."

Hoefer sees access as a huge advantage to the online format of health promotion.  Another advantage is the ability to upload new content and intervention modules as new knowledge becomes available. 

As with all things web-based, unforeseen challenges arose as study participants worked through the project. This means that Hoefer and his team must occasionally act as technology support when users find themselves using incompatible web browsers, video players and device hardware. "A unique challenge to a project like this is the rapid change in technology," says Hoefer. "Some of the elements built just a few years ago have already needed updates and the hardware being used to access it is obviously different. Nobody even knew what an iPad was when we began this process. But that's one of the inspiring  questions: how can we use these tools to bring sexual health information to people where they're able to absorb it?"

Findings from this study will be used to develop further online interventions to promote the health and well-being of transgender people and their partners.

The All Gender Health research team includes Walter Bockting, PhD (principal investigator), Eli Coleman, PhD, Jamie Feldman, MD, PhD, Cesar Gonzalez, PhD, Stephanie Hengst, Chris Hoefer (project coordinator), Keith Horvath, PhD (epidemiology), Michael Miner, PhD, Bean Robinson, PhD, , Rebecca Swinburne Romine, PhD, and David Valentine, PhD (anthropology).

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On World AIDS Day, it is certainly a poignant time to reflect on our progress and to reinvigorate our determination to halt this epidemic.  We have encouraging news.  The rates of HIV have fallen to the lowest levels since the peak of the epidemic, new HIV infections were reduced by 21% since 1997, and deaths from AIDS-related illnesses decreased by 21% since 2005 (UNAIDS, 2011).  

While these are encouraging statistics, there are still parts of the world including our own country in which the epidemic rages on.  The number of new HIV infections continues to rise in Eastern Europe, Central Asia, Oceania, the Middle-East, and North Africa.   Here in the US - we still see rises in certain urban centers (particularly among African Americans and men who have sex with men) and, overall, we see an increase in HIV infections in the South-east (particularly in poorest areas).

Poverty is still a major predictor of risk of HIV infection.  The poor, disenfranchised, stigmatized, and marginalized bear the overall burden of disease and HIV remains a serious threat.  Thus racial and sexual minorities are still very much at risk.  Youth in these groups are particularly vulnerable.   

While we need to address the serious issues of poverty, discrimination, prejudice, and the lack of basic sexual rights, we know that even the disenfranchised can be empowered through comprehensive sexuality education and access to preventative services.  We need to put HIV prevention in the context of a comprehensive sexuality approach.

We can be encouraged by the fact that when youth are educated with comprehensive sexuality education, they are more likely to delay the onset of sexual intercourse and use condoms.  We know that condoms are highly effective in preventing the spread of HIV and other sexually transmitted infections.  While the effects of stigma and discrimination are still a powerful force, comprehensive sexuality education can lead to empowerment.

We need an HIV-prevention approach that is sex-positive recognizing that people have a basic instinct and drive to be sexual and that beyond the reproductive utility of sexual activity, people are motivated to experience pleasure and that sex is a fundamental form of communication and expressing intimacy.  We have spent too much time on de-sexualizing HIV prevention, now it is time to promote what I have termed "sexualized HIV prevention."  Let's bring positive sexuality back into HIV prevention - and let's focus on the marginalized populations and empower them to enjoy a fulfilling and pleasurable sexual life.

Eli Coleman, PhD
Director and Professor
Chair in Sexual Health

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On November 2, 2011, Senator Frank Lautenberg (D-NJ) and Representative Barbara Lee (D-CA) introduced the Real Education for Healthy Youth Act (HR 3324), a new bill that lays out a comprehensive, age-appropriate, and holistic vision for sex education policy in the United States.

The bill currently has 31 cosponsors. It has been referred to the Committee on Energy and Commerce, and in addition to the Committee on Education and the Workforce.

Overview of Real Education for Healthy Youth Act (HR 3324)

To provide for the reduction of unintended pregnancy and sexually transmitted infections, including HIV, and the promotion of healthy relationships, and for other purposes

SEC. 2. PURPOSES; SENSE OF CONGRESS
(a) Purpose- The purposes of this Act are--

(1) to provide young people with comprehensive sex education that--

(A) provides the information and skills young people need to make informed, responsible, and healthy decisions in order to become sexually healthy adults and have healthy relationships;

(B) provides information about the prevention of unintended pregnancy, sexually transmitted infections, including HIV, sexual assault, dating violence, bullying, and harassment; and

(C) promotes and upholds the rights of young people to information in order to make healthy and responsible decisions about their sexual health; and

(2) in order to provide the comprehensive sex education described in paragraph (1), to provide increased resources for sex education programs that--

(A) are evidence-based, having been proven through rigorous evaluation to change sexual behavior or incorporate characteristics of effective programs;

(B) cover a broad range of topics, including medically accurate, complete, age and developmentally appropriate information about all the aspects of sex needed for a complete sex education program, including--

(i) anatomy and physiology;
(ii) growth and development;
(iii) healthy relationships;
(iv) the prevention of unintended pregnancy and sexually transmitted infections, including HIV, through abstinence and contraception;
(v) gender, gender identity, and sexual orientation; and
(vi) protection from dating violence, sexual assault, bullying, and harassment;

(C) are gender- and gender identity-sensitive, emphasizing the importance of equality and the social environment for achieving sexual and reproductive health and overall well-being;

(D) promote educational achievement, critical thinking, decisionmaking, self-esteem, and self-efficacy;

(E) help develop healthy attitudes and insights necessary for understanding relationships between oneself and others and society;

(F) foster leadership skills and community engagement by--

(i) promoting principles of fairness, human dignity, and respect; and
(ii) engaging young people as partners in their communities; and

(G) are culturally and linguistically appropriate, reflecting the diverse circumstances and realities of young people.

The entire bill can be read at the Library of Congress website

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In September Naek Tobing, PhD, returned to Minnesota and the Program in Human Sexuality from his home in Jakarta, Indonesia. 

Tobing trained as a sex therapist at PHS in 1983. Since returning to Indonesia he has built a private practice in sexual health and marital counseling where he sees patients, provides education to the public and medical professionals, conducts research, and publically advocates for sexual health. In February, Tobing worked with Indonesian Psychiatric Association to hold a three day seminar and workshop on sexual health which hosted 115 participants.

Tobing is grateful for the training he received at PHS.  He said, "I learned how to handle patients, individually and mostly in group therapy. I also learned about many kinds of sexual and marital problems."

Tobing writes about sexuality and relationships in a column for the women's magazine Kartini (since 1984), and he also writes for the most popular tabloid Nyata.  Until it was banned, Tobing had a popular weekly television program about sexual health.

During his visit to the United States Tobing visited family including his granddaughter who is in her second year of studying economics at the University of Minnesota.

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We have reached a moment in history with serious global economic challenges and critical and costly sexual health problems. Around the world governments as well as regional and international health agencies are recognizing the importance of having a unified and broad sexual health approach to reduce the burden of disease related to sexual health problems.

There have been several recent, major developments which will certainly have a positive impact on the promotion of sexual health. First, there has been an effort by the Centers for Disease Control and Prevention to consolidate its initiatives in HIV prevention, STI prevention, reproductive health, school-based sexuality education, and sexual violence prevention under a broader and unified effort to promote sexual health as an overarching strategy to deal with the myriad of sexual health problems we face in this country, A Public Health Approach to Advancing Sexual Health in the United States. Second, in July 2010 the White House released a National HIV/AIDS Strategy that acknowledges the importance of addressing sexual health through prevention activities rather than simply more "testing and pills." Third, in March 2011, the Institute of Medicine released its report on The Health of Lesbian, Gay, Bisexual and Transgender People. Finally, in June 2011 the National Prevention, Health Promotion, and Pubic Health Council in the Office of the Surgeon General released a National Prevention Strategy which includes a major section on promoting sexual and reproductive health.

The synergy of these efforts has put sexual health squarely in the center of public health strategies to improve the overall health and wellbeing of all Americans. While PHS has been promoting sexual health for over 40 years, the concept of sexual health has taken root in public policy in a way that represents a revolutionary paradigm shift. It is an exciting time.

We hope that this will translate into improved funding for a strategic approach to change the sexual health climate of this country - using the powerful resources of our government. We hope that this will increase research grants, educational opportunities, and provisions for sexual health care.

During the past decade, it seemed that the leaders in sexual health were in other parts of the world. Now, the US has joined similar international efforts and may be able to assume a leadership role by advancing sexual health through public policy and public health.

PHS is involved in many of these national, regional, and international efforts. Hopefully, through this work, we will truly realize a sexually healthier climate here and around the world. It is an exciting time - a time to "strike while the iron is hot" to consolidate efforts and move the sexual health agenda forward.

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Eli Coleman, PhD, participated in an expert technical consultation for the Centers for Disease Control and Prevention (CDC) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) on advancing sexual health in the United States. The project began in April 2010 when the CDC brought together 67 experts with a variety of back grounds and interests in sexual health including individuals from public interest groups, communities of faith, sexual health researchers, professional organizations, media and communications, private sector businesses, and government agencies. In May 2011 the group released a report that highlights the expert consultation proceedings titled A Public Health Approach for Advancing Sexual Health in the United States: Rationale and Options for Implementation. The report is intended to engage future partners and spur continued conversations for the initiative.

The CDC launched the initiative in recognition that sexual health is an essential component of overall individual health, that individual sexual health has a major impact on the health of communities, and that a national dialogue is critical in improving population health. The group worked to identify initiatives aimed at implementing a public health approach to promote age-appropriate sexual health. One that is consistent with the best available science, including healthy, respectful, and responsible sexual behavior, for all Americans over their lives.

Consultants were challenged to identify actions around six goals including:
1. Increase healthy, responsible, and respectful sexual behaviors and attitudes.
2. Increase the ability and awareness to make healthy and responsible choices, free of coercion.
3. Promote healthy sexuality, healthy sexual functioning, healthy relationships, and respectful sexual rights for all persons throughout the life span.
4. Optimize and educate about reproductive health choices.
5. Increase access to effective preventive, screening, treatment, and support services that promote sexual health.
6. Decrease adverse individual and public health outcomes including HIV/STDs, viral hepatitis, unintended pregnancies, and sexual violence.

In 2001 Surgeon General David Satcher, MD, PhD, released The Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior. The new CDC report states that, "Over 10 years later, many measures of adverse health outcomes of sexual behaviors have worsened, prompting a need for refocused national attention on sexual health-related issues, especially HIV prevention and adolescent sexual health outcomes (e.g., unplanned pregnancy and STDs.)" The new CDC efforts will help to revitalize the goals and guidelines from the Call to Action while incorporating new research and current perspectives.

Centers for Disease Control and Prevention. A Public Health Approach for Advancing Sexual Health in the United States: Rationale and Options for Implementation, Meeting Report of an External Consultation. Atlanta, Georgia: Centers for Disease Control and Prevention; December, 2010.

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