Men's Sexual Health

Article excerpt

Men's Sexual Health by Ian Peate. London: Whurr Publishers, 2003, 165 pp.

Readers of the International Journal of Men 's Health will not be surprised that we are seeing increasing specialization with regard to the subject of men's health. Whether this diversification is sociocultural (with different perspectives coming from different regions of the world) or medical (in relation to the established concerns of cardiovascular health or testicular and prostate cancer), the field is opening up to disciplinary scrutiny from a number of health and social scientific perspectives. Men 's Sexual Health, by Ian Peate, while including testicular cancer and prostate disease as specific topics, addresses a wider range of sexual health issues, notably sexually transmitted infections (STIs) and erectile dysfunction, and is to be cautiously welcomed as an accessible introductory text.

A first coda to this general welcome, however, is that it is written from a British perspective and is directed primarily at nurses working in the UK National Health Service. It is difficult to see whether it could achieve a broader appeal, even in nursing, and there are some questions as to whether it would prove useful to nurses in primary and secondary care settings, particularly in genitourinary medicine and reproductive health, for reasons given below.

Three introductory chapters ("Men's Bodies," "Health Education/Promotion," and "Epidemiology") are pitched at a somewhat general level rather than being sexual health-specific, although in the health promotion chapter examples from sexual health are more prominent. The epidemiology chapter concentrates more on social demographic rather than epidemiological data per se, and this limits the potential appeal of the text even further to the UK context. However, even here there are some disappointing absences. Peate fails to reference the National Surveys of Sexual Attitudes and Behaviour (Natsal) undertaken in 1990 and 2000. These major UK behavioral and epidemiological surveys investigated the sexual behavior of men in a rigorous and systematic manner. This omission is somewhat unusual, and although many of the key papers from the second Natsal post-date the publication of this text, the insights provided by the first Natsal (e.g., on numbers of partners, use of prostitutes, and prevalence of same-sex activity) may have helped in contextualizing issues raised subsequently.

Chapters 4 through 7 do a workman-like job of addressing the main sexual health issues facing men (testicular cancer, erectile dysfunction, disease of the prostate, and STIs), usually done from a robustly medical perspective. However, there are some important and worrying gaps. The focus on only three STIs (gonorrhea, genital chlamydia, and syphilis) is certainly limited and limiting. Failures to discuss HIV (clearly important for gay men but also for heterosexual men of subSaharan African origin living in the UK) or other viral infections and their clinical presentation (human pupilloma virus and genital warts, herpes simplex virus types 1 and 2, and genital herpes) are key omissions. …