Department of Sociomedical Sciences, Columbia University, New York, NY, United States.
Population Reference Bureau, Washington, DC, United States.
Front Public Health. 2023 Jan 26;10:1040097. doi: 10.3389/fpubh.2022.1040097. eCollection 2022.
Today, we are facing increased and continued adverse sexual health outcomes in the United States, including high post-COVID-19 pandemic rates of sexually transmitted infections (STIs). For the past 20 years, there have been calls for a national health strategy and a more comprehensive sexual health approach to address the myriad of persistent sexual health problems in this country. Employing a sexual health approach requires shifting from a longstanding, stigmatizing focus on morbidity toward a holistic and integrated focus on health rather than disease. While strategies are being implemented by multisectoral stakeholders, it is also important to establish a core set of indicators that broadly describe the state of sexual health in the U.S. and allow for measurement across time. The development of a comprehensive scorecard with key sexual health indicators has been proposed by other entities (e.g., Public Health England, World Health Organization), but such an attempt has not been made in the U.S.
A review of national U.S. surveys and surveillance systems with items related to sexual health was conducted for years 2010-2022 to develop an inventory of existing data that yield national estimates for potential indicators of sexual health.
We selected 23 sexual health indicators in four broad domains including: (1) knowledge; communication and attitudes (five indicators); (2) behaviors and relationships (four indicators); (3) service access and utilization (seven indicators); and (4) adverse health outcomes (seven indicators). Recent data for each indicator are provided.
A growing body of evidence shows the positive effects of moving away from a morbidity focus toward an integrated, health-promoting approach to sexual health. Yet, not much has been done in terms of how we implement this national shift. We argue that measurement and monitoring are key to future change. We envision these core sexual health indicators would be published in the form of an index that is publicly available and updated frequently. These sexual health indicators could be used for ongoing monitoring, and to guide related research, programming, and policy development to help promote sexual health in coming years.
如今，美国面临着越来越多且持续存在的不良性健康后果，包括大流行后性传播感染（STI）的高发率。在过去的 20 年中，人们一直在呼吁制定一项国家卫生战略和更全面的性健康方法，以解决这个国家存在的众多持续存在的性健康问题。采用性健康方法需要从长期以来对发病率的污名化关注转变为对健康而不是疾病的整体和综合关注。虽然多部门利益相关者正在实施各种战略，但建立一套广泛描述美国性健康状况并允许随时间进行衡量的核心指标集也很重要。其他实体（例如，英国公共卫生署、世界卫生组织）已经提出了制定包含关键性健康指标的综合记分卡的建议，但美国尚未尝试过。
对 2010 年至 2022 年期间与性健康相关的美国全国性调查和监测系统进行了审查，以开发一份现有数据清单，这些数据可提供性健康潜在指标的全国估计值。
我们选择了四个广泛领域中的 23 个性健康指标，包括：（1）知识；沟通和态度（五个指标）；（2）行为和关系（四个指标）；（3）服务获取和利用（七个指标）；（4）不良健康结果（七个指标）。提供了每个指标的最新数据。
越来越多的证据表明，从关注发病率转变为采取综合的、促进健康的性健康方法会产生积极影响。然而，在我们如何实施这一国家转变方面，我们并没有做太多工作。我们认为衡量和监测是未来变革的关键。我们设想这些核心性健康指标将以公开提供和经常更新的指数形式发布。这些性健康指标可用于持续监测，并指导相关研究、规划和政策制定，以帮助促进未来几年的性健康。
