‘We Do Not Use The Word “Crisis” Lightly …’

At the turn of the twenty-first century, health professionals, the media and politicians identified ‘sexual health’ as a policy problem in the UK. Despite publication in 2001 of a National Strategy for Sexual Health and HIV for England, in 2003 the House of Commons Health Committee issued a damning report on what they perceived to be the continuing ‘crisis’ in sexual health. The Committee described increasing rates of sexually transmitted infection and stubbornly high rates of teenage pregnancy among other issues. This article follows Hudson and Lowe (2004) in applying the distinction between macro, meso and micro levels of analysis, but particularly focuses on the meso level: ‘how policies come to be made, who puts them on the policy agenda and the structure of the institutional arrangements in which policy is defined and eventually implemented’. This article describes the ambiguous historical inheritance through which sexual health policy has been shaped, including the focus on sexually transmitted infections and teenage pregnancy, and the emergence of a sexual health policy community. Continuing tensions and silences in policy are identified. The article argues that UK sexual health policy follows a cyclical pattern of neglect interspersed with occasional ‘crises’ resulting in narrowly disease focused incremental change.