Enhancing sexual health in primary care: Guidance for practitioners

Abstract

Sexual health is an integral aspect of overall health and well-being and is fundamental to the sustainable development of societies  worldwide. The World Health Organization (WHO) defines sexual health as ‘a state of physical, emotional, mental, and social well-being in  relation to sexuality’. However, addressing sexual health has been afforded low priority in primary healthcare systems. Primary care  practitioners (PCPs), who play a crucial role in providing comprehensive care to communities, receive little training on screening and  managing individuals with sexual health problems. The scope of services ranges from education, prevention and screening, to  management of sexual health matters. Patients with noncommunicable diseases (NCDs), such as stroke, cancer, heart disease and  diabetes, are at increased risk for sexual dysfunction, possibly because of common pathogenetic mechanisms, such as inflammation. This  is of considerable importance in the sub-Saharan African context where there is a rapidly increasing prevalence of NCDs, as well as a  high burden of HIV. Strategies to improve the quality of sexual health services in primary care include creating a safe and non- judgemental practice environment for history-taking among gender-diverse populations, utilising effective screening tools aligned with  the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for sexual dysfunctions. In particular, the International  Consultation on Sexual Medicine (ICSM -5) diagnostic and treatment algorithm can empower primary care providers to effectively  address sexual dysfunctions among patients and improve the quality of care provided to communities regarding sexual and reproductive  health.