SEXUALITY - THE MISSING LINK IN WOMENS HEALTH

This article outlines some of the ways in which women are particularly vulnerable to risk in relation to their sexuality, and suggests how primary health care programme could begin to address the impact of sexuality on health in a holistic and gender specific way. The article disucsses the cultural and economic determinants of sexual expression and explores how these influence people's options for practising safer sex. Personal values around sexuality have a particularly profound influence on programme design and implementation. The first steps in any programme would be an exploration of how sexuality relates to health in different groups, followed by training which enables staff to address this area comfortably without imposing their own values. A genuinely participatory programme would acknowledge sexual diversity and respond to a range of needs. It would aim to empower people to make their own informed decisions, explore their values and practise skills. Often a development approach will be needed which involves activities outside the normal remit of the health sector. Integrating sexuality into PHC in this could have far-reaching consequences. At the very least, it would highlight the way in which existing power relations between men and women, generations and people with different sexual orientations have severely detrimental effects on the health of the whole community.