SEXUAL HEALTH AND REPRODUCTIVE HEALTH: DEFINING THE RELATIONSHIP

Conceptually, sexual health and reproductive health are interlinked both directly and indirectly. Since the ICPD (International Conference on Population and Development) meeting, the term “sexual and reproductive health” has become standard in most parts of the world, although in some regions there are cultural and political sensitivities that limit use of the term sexual health, where the term reproductive health is interpreted and made operational as one that implicitly includes sexual health-related issues.

In recent years, the ICPD definition of sexual health as a component of reproductive health has been questioned, since it has been widely recognized that sexual health encompasses more than reproductive health. This underlines the importance of considering sexual health in its own right. Rather than being a component of reproductive health, sexual health underlies, and is a necessary condition for, the achievement of reproductive health.

Sexuality and sexual relations are central to both reproductive and sexual health, but since most sexual activity is not directly associated with reproduction and is of relevance throughout the lifespan, sexual health may be considered as a broader concept. For example, sexual health recognizes the desire of individuals and couples of all sexual orientations to have fulfilling and pleasurable sexual relationships. Sexual health concerns, therefore, go beyond fertility and reproduction to encompass issues such as sexual dysfunction and disability, as well as violence related to sexuality. All these issues do not necessarily fit well into a framework devoted exclusively to reproductive health.

To attain reproductive health, people need to be able to exercise control over their sexual health and life, and to achieve healthy sexuality. Sexuality and the dynamics of sexual relationships have a fundamental influence on the uptake and use of contraceptives, the risk of sexually transmitted infections (including HIV), and pregnancy and abortion. Important sexuality-related issues include the nature and frequency of sexual acts, the conditions of choice or coercion that motivate the acts, the meanings associated with them, the perception and experience of sexual drive and pleasure, the choice and number of sexual partners, and the formation and complexity of a person's sexual identity (Dixon-Mueller, 1993). Everywhere in the world, these conditions and their complexity are mediated and defined by gender relations and norms.

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