become more involved in educating others regarding STDs. These key individuals include parents, educators, health professionals, persons in the mass media, and religious leaders. It is important that clinicians, educators, and researchers become more skilled at discussing sexuality and learn more about sexuality. Improved skills in these areas will not only improve the effectiveness of behavioral interventions for STDs, but also for reproductive health problems in general. Clinicians, in particular, need to understand the context in which high-risk sexual behaviors occur, as well as the social and cultural factors that reinforce these behaviors. It is often difficult for professionals to remain objective during clinical interactions because sexuality is an emotionally charged issue, especially when the professional's own beliefs and behaviors differ from those of the patient.

Research on sexuality provides the basis for understanding the determinants of risky sexual behaviors. Two formidable barriers to strengthening and developing social and behavioral research in sexuality and STD-related risk behaviors are the lack of comprehensive research training in sexuality and inadequate funding of both basic (e.g., research on determinants of behavior change) and applied (e.g., behavior change interventions) research. The continuing fragmentation of the social science fields in sexuality research, the low status given to sexuality research, and lack of sufficient research funding all hinder training in this area. Inadequate dissemination of existing data has also hampered development of interventions and policy initiatives.

All appropriate clinical opportunities to counsel patients regarding healthy sexual behaviors should be utilized. To improve effectiveness of behavioral interventions, clinicians, educators, and researchers need training and skills to deal with issues related to human sexuality and STDs among their patients and students. Providing new, and enhancing existing, continuing education courses for clinicians, educators, and researchers will help these professionals become more comfortable working with sexual health issues. Courses designed to educate all these professionals about sexuality, attitudes, alternative lifestyles, and cultural factors will provide a fuller understanding of sexual behavior.

Therefore, the committee makes the following recommendation:

  • The Health Resources and Services Administration, health professional schools and associations, and schools and associations for training educators should support comprehensive sexuality training for health care professionals, educators, and researchers in order to increase their comfort in working with sexual health issues and to increase their effectiveness in sexual behavior counseling. Health professional schools and associations should sponsor continuing education courses in sexuality for clinicians and incorporate appropriate instruction in undergraduate and graduate education programs. The focus of these programs should be to provide instruction in basic, effective intervention counseling and clinical skills that are appropriate for any setting or population.

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