Sexual Wellbeing

Why we ask people about their sexual wellbeing

Sexual Health and Wellbeing can often be overlooked when talking to Service Users, partly due to other issues presenting as being of more significance and often partly due to the discomfort that still exists in Ireland in relation to Sexual Health. We as workers can often view it as a ‘private and embarrassing matter’ for Service Users and they pick up on this discomfort and sometimes we just don’t know where to start.

Positive sexual health is an integral part of all of us regardless of our circumstances. Many of the Sexual Health Centre’s Service Users who have or are in active addiction say it is the only thing they still feel in control of, while Service Users in recovery feel it is the only thing they are still “allowed” to have. Often when we meet Service Users in recovery they will say that they are terrified of “sober sex”, or have been worried about sexual encounters in the past and may have themselves in states of massive anxiety when in fact the risk that they are worried about may not be that large at all. Talking about sexual health is not just about STIs, HIV and ticking a box it can be so much more… a simple question like “Do you want condoms” can lead to a straight Yes or No if we let it or it can develop into a discussion in relation to self-esteem, shame, desire, fear, mental health, fertility, loneliness and so much more. (Sexual Health Centre 2018)

  • Crisis Pregnancy: Over one-third (35%) of women who have had experience of pregnancy have had a crisis pregnancy. Crisis pregnancy is defined in Irish legislation ‘as a pregnancy which is neither planned nor desired by the woman concerned and which represents a personal crisis for her’. The rate of teenage pregnancy has declined from 20 births per 1,000 females aged 15–19 years in 2000 to 12 per 1,000 in 2012.
  • Sexual Transmitted Infections (STI’s): There is concern over the general upward trend in STI notifications, which in the period 1995–2013 saw increases from 3,361 to 12,753. In 2013, 344 people were newly diagnosed with HIV in Ireland, a rate of 7.5 per 100,000 head of population. The Health Protection Surveillance Centre (HPSC) report that the greatest burden of STIs falls among those aged under 25 years and among men who have sex with men (MSM).
  • The aims of sexual health promotion, education and prevention initiatives are: to encourage the development of a healthy sexuality throughout life; to enhance people’s lives and relationships; to reduce negative outcomes such as STIs and crisis pregnancies; and to create an environment that supports sexual health and wellbeing. Sexual health promotion, education and prevention strategies work to address a range of issues such as challenging stigma and discrimination, promoting healthy attitudes and values, and challenging perceptions of risk. Interventions include: relationship and sexuality education; public health campaigns; condom distribution; targeted outreach; counselling and support; testing; vaccination; and medication programmes.

Sexual health service to the public include: clinical services for the diagnosis and management of STIs; contraception services/family planning services; counselling; information and support services; community outreach services for sexual health promotion; education and information; support; and crisis pregnancy management. There is a need to map existing services in order to provide a clear picture of the array, quality, efficiency, accessibility and availability of clinical services and to carry out a needs assessment for services to inform the implementation of this Strategy. (National Health Strategy 2015)