Men's sexual health matters: promoting reproductive health in an international context.

Recent concern regarding the control of sexually transmitted infections (STIs) has resulted in an increased interest in the sexual health of men. This interest has primarily focused on strategies to 'encourage and enable men to take responsibility for their sexual and reproductive behaviour and their social and family roles' (United Nations 1994). Whilst men are deemed to have 'responsibilities', women are said to have 'rights' with regard to making choices about reproductive health and accessing appropriate and effective services. Here it is argued that, whilst provision of services and interventions against STIs in men should never be at the expense of those for women, it is often clinically easier and more effective to diagnose and treat men with STIs compared to women in resource-poor settings. Indeed, this may prove to be an effective strategy in controlling the spread of STIs, and hence reducing the disproportionate burden of their complications suffered by women. The paper reviews key issues in relation to improved service delivery for sexual and reproductive health in men, notably: the heterogeneity of male populations; current knowledge regarding men's sexual behaviour; the role of sexuality; methods of studying sexual behaviour in resource poor countries; men's own concerns in relation to sexual and reproductive health; and where and how they access treatment. It is argued that the time has now come to determine and address men's sexual health needs if we are to expect them to participate fully as responsible partners in improving and protecting their own and others' sexual and reproductive health.