Sexual Health: An Australian Perspective.(Book review)

SEXUAL HEALTH: AN AUSTRALIAN PERSPECTIVE Meredith Temple-Smith and Sandra Gifford (eds) Melbourne: IP Communications, 2005, ISBN 0975237411 335 pp, PB, AUD 65.00.

If ever a search was made for the holy grail of a unified field theory of sexual health, medicine and social sciences, then this book comes close to it. No longer is sexual health the exclusive domain of the physical and biological, an activity that takes place 'between the sheets' or to be privately discussed between patient and doctor. Sexual health is multi-faceted, viewed in an all-encompassing framework that involves the complex and interdependent relationships between biology, psychology and socio-historical-cultural factors.

The book sets out this multi-dimensional and multi-disciplinary framework in five parts. Part 1 offers a concise history and selected studies on sexual health in Australia; Part 2 discusses male and female biological functions and provides psychological and anthropological perspectives on sexual health; Part 3 discusses sexually transmissible infections found commonly in Australia and talks about factors affecting sexual functioning; Part 4 evaluates sexual health inequalities in Indigenous and other marginalised populations; and Part 5 is a review of Australian health promotion and sexual health policy. Experts from various fields including medicine, reproductive biology, microbiology, public health, criminal justice, law, anthropology, psychology and health services have all contributed to the collection, giving each of the nineteen chapters a different outlook on sexual health.

I was fascinated by Meredith Temple-Smith's historical account of Indigenous and non-Indigenous sexual health in pre- and post-convict settlement in Australia. She argues that attitudes towards race, class and gender, molded by the prevailing moral culture of the day, have produced inequalities in sexual health services and care for people with venereal disease. The chapter races through the time periods, from sexual health prior to colonisation, to the decades in between, and then to modern day Australia. Unfortunately, the overview gives a somewhat disjointed historical account of contraception in Australia, the discussion sometimes swinging unexpectedly between venereal disease and contraception without linking them to each other except through the a time period. 'Contraception' would have been better placed in its own section in the chapter.

Another highlight is the results of the first large-scale sexual health and behavioural survey undertaken in Australia by Anthony Smith et al. Some 19,307 Australians between 16 and 59 years participated in the study. Did you know that the onset of sexual activity declined from 18 to 16 years among Australian men born between 1981 and 1986 and from 19 to 16 years among women, that 15.6% of Australian men and 0.1% of women had paid for sex at some time in their life, and that 4.8% of men and 21.1% of women had been forced or frightened into unwanted sex in their lifetime? Like the research conducted by the famous zoologist and sexologist Alfred Kinsey, this chapter explains in detail the sexual behaviours of Australian men and women and what they get up to behind closed doors.

Part 4 is a special section on marginalised and stigmatised populations and their poorer sexual health outcomes compared with the general population. This section will raise the reader's awareness of race, ...