背景与目的      Background and Objectives

历史背景   Historical Background

根本原因   Rationale

磋商目标   Consultation Objectives

中文翻译：彭晓辉（中国 武汉 华中师范大学生命科学学院 430079）完成时间：2006年3月
Translator：Xiaohui Peng (Life Science College of CCNU, Wuhan, 430079, China)
校   对：吴敏伦（中国 香港 香港大学医学院）完成时间：2006年8月

背景与目的

历史背景

人类性学教育与性治疗大会：1974年2月6日-12日，世界卫生组织(World Health Organization，简称WHO)在日内瓦举行了卫生保健专业人员培训。应邀出席培训的学员来自不同的国家，他们在人类性学领域具有教育、研究和临床专业知识与实践方面的经验。大会旨在对下列领域做出重要的评论和提出建议：

在健康项目中性科学的作用，尤其在家庭计划行为中的作用；

对卫生保健专业的人类性学的教学内容与教学方法；

人类性学的教育与性治疗项目的启动、组织和执行；

性科学领域的参考文献与合作的国际服务。

认同适合于应对多元社会文化环境优先需求和由一般卫生工作者实践的治疗和咨询模式；

这次研讨会的成果以“人类性学教育与性治疗：卫生专业人员的培训”[i]的文件形式提出了报告。这是一个为卫生保健专业人员提供必需的性教育、性咨询和性治疗的改进培训铺平道路的历史性文件。它也为在全球发展性科学和建立性信息资源中心起到了激发的作用。

世界卫生组织欧洲部继而专门针对这个文件的内容举办了后续的两次会议[ii]。可是，这个报告并没有被广泛传播，因此，报告所建议的行动方案并没有如提议的那样被广泛地采纳。

自从第一个文件出版25年已经过去了，在人类性学领域和其他相关知识领域已经有了长足的发展。这些个发展丰富和加深了我们对性教育、性咨询和性治疗复杂性的理解和认识。通过研究，已经甄别出哪些方法和干预措施有效，哪些无效。现在出现了新的难题，尤其是出现的了HIV/AIDS的全球流行，让我们越来越意识到：现时的紧迫需要已经摆在了我们的面前，那就是加强性方面的培训并更加步调一致和采取更全面的手段对付性健康问题。

为了扩大和丰富早先已经取得的成果，在世界性学会(the World Association for Sexology，简称WAS)的协作下，泛美卫生组织(Pan American Health Organization，简称PAHO)召集了一个区域磋商会议，为的是重新研究和分析如何促进性健康，其中还研究了卫生保健部门在达到和维持性健康中的任务。本文件就是这次磋商会议的结果。磋商会议于2000年5月19日-22日在危地马拉的安提瓜岛举行。

根本原因

在过去的25年里，与性健康最为密切的一些领域已经有了相当大的发展。这些发展包括：

人类性学各个方面的知识进展。这种进展是通过理论质询、生物医学、心理学、社会学、人类学的研究以及通过流行病学监测与临床工作而达到的。这些学科及其诸方面的研究为人类性学这个异常复杂的学科领域的发展做出了贡献。人类性学则超越了上述每一个单独的学科所涵盖的范围。

HIV全球流行的出现和不断意识到的其它性传播疾病的冲击[iii]。这些难题的有效解决有赖于成功地改变人们的各种行为模式和性习惯。所以，促进行为改变的能力高度地倚赖于人们对人类性学的充分理解[iv]。

源自女权主义者的著述和见解的多方面知识体系的形成。这种知识表明社会是由一系列复杂的和无所不在的一系列规则和前提条件所关联和所调节的，这些规则和前提条件渗透社会的每一个方面并恰好成为这个知识体系的构成部分。这种女权主义者的性别视角已经揭示，如果忽视了“男性特性”与“女性特性”的文化概念，人类性学的任何考量都不可能是完整的[v]。

生殖健康领域的界定和强化。在国际人口与发展大会行动计划(Program of Action of the International Conference on Population and Development)里，尤其包括性健康在内的生殖健康被列入优先的考虑范围[vi]。

重视社会暴力问题，其中包括重视性暴力问题，尤其把针对妇女、儿童和性少数的性暴力视为一个严重的公共卫生问题[vii]。

公认性权利作为人权的一部分。世界上有数个国际组织，诸如国际计划生育联盟(International Planned Parenthood Federation)[viii]和世界性学会[ix]等，已经明确地承认和声明了性权利。可是，1994年在开罗召开的国际人口与发展大会(International Conference on Population and Development，简称ICPD)和1995年在北京召开的第四届世界妇女大会(the Fourth World Conference on Women)上，性权利常常只在生殖方面获得了认可[x]。因而，需要采取更全面的理性态度以达到对性权利的完全共识。

越来越多的社会运动呼吁重视、尊重和保护“性少数群体”(诸如男同性恋者、女同性恋者和跨性者)的权利。

研制与改进有效而安全的药物以调节和改善个人的性功能。这已经促使人们的兴趣重新关注于性功能障碍和强迫性行为的流行病学和因果关系的研究^xi。

磋商目标

现时的磋商目标如下：

制定性健康促进的概念框架

鉴别美洲国家区域内的性健康忧虑(Sexual Health concerns)和性健康问题(Sexual Health problems)

提出达到和维持性健康的行动方案和策略建议

Background and Objectives

Historical Background

A Meeting on Education and Treatment of Human Sexuality: The Training of Health Professionals was convened by the World Health Organization (WHO) in Geneva from 6 to 12 February 1974. The participants were invited to attend on the basis of their special knowledge and experience in teaching, research, or clinical practice in the field of human sexuality in various countries. The meeting was asked to make a critical review of, and to develop recommendations in, the following areas:

the role of sexology in health programs, particularly in family planning activities;

the content and methodology of teaching in human sexuality to the health professions;

the identification of treatment and counseling models suitable to meet the priority needs in various sociocultural contexts and to be practiced by general health workers;

the initiation, organization, and implementation of teaching and treatment programs in human sexuality;

the international services for reference and coordination in the field of sexology.

The conclusions of this meeting were reported in the document Education and Treatment in Human Sexuality: The Training of Health Professionals ¹. This was a historic document that paved the way for improved training of health professionals to provide the necessary sexual education, counseling and therapy. It also served as a stimulus for the development of the field of sexology and sexual resources centers throughout the world.

Two subsequent meetings of the European Office of the WHO have addressed issues relating to this document ². However, the reports were not widely disseminated and hence, the actions proposed were not widely undertaken as suggested.

In the twenty-five years that have elapsed since the publication of the first document, many developments have occurred in the field of human sexuality and other related fields of knowledge. These developments have enriched our understanding and awareness of the complexity of the sexual education, counseling and treatment. Research has identified approaches and interventions that are effective, and those that are not. The emergence of new problems, notably the HIV/AIDS pandemic, has raised our awareness of current urgent needs for enhanced sexuality training and a much more concerted and comprehensive approach to addressing sexuality problems.

In order to extend and enhance previous efforts, the Pan American Health Organization (PAHO) in collaboration with the World Association for Sexology called a regional consultation to re-examine how to promote Sexual Health including the role of the health sector in the achievement and maintenance of Sexual Health. This document is the result of this consultation held in Antigua Guatemala, Guatemala, on May 19 to 22, 2000.

Rationale

Some of the most relevant developments concerning Sexual Health have occurred in the past twenty-five years. These developments include:

Advances in knowledge about different aspects of human sexuality. This has been achieved through theoretical inquiry, biomedical, psychological, sociological and anthropological research, epidemiological surveillance and clinical work--that have contributed to the development of an extremely complex field, transcending each of the individual disciplines it encompasses.

The emergence of the HIV pandemic and increased awareness of the impact of other sexually transmitted infections ³. The effective control of these problems relies upon successfully changing the behaviors and sexual practices of people. The ability to promote behavioral change is, therefore, highly dependent on an adequate understanding of human sexuality ⁴.

Formation of a solid body of knowledge originated in the writings and views of feminist scholars. This knowledge indicates that societies are articulated and regulated by a complex and pervasive set of rules and assumptions that permeate every aspect of the society and the very construction of knowledge. The gender perspective has shown that any consideration of human sexuality cannot be complete if it ignores the cultural concepts of “masculinity” and “femininity.” ⁵

Definition and consolidation of the field of reproductive health. In particular, the priority consideration given to reproductive health, including Sexual Health, in the Program of Action of the International Conference on Population and Development. ⁶

Recognition of violence, including sexual violence, especially against women, children and sexual minorities, as a serious public health issue ⁷.

Recognition of sexual rights as human rights. Sexual rights have been explicitly recognized and stated by groups such as the International Planned Parenthood Federation ⁸ and by the World Association for Sexology ⁹. However, sexual rights have often only been recognized in their reproductive dimension as in the 1994 International Conference on Population and Development (ICPD) in Cairo, as well as at the Fourth World Conference on Women (Beijing, 1995) ¹⁰. A more comprehensive stance needs to be taken to achieve full recognition of sexual rights.

Increased advocacy by social movements for recognition, respect and the protection of the rights of “minorities” (such as gay, lesbian, and transgender individuals.)

Development of effective and safe medications to modify and improve the sexual functioning of individuals. This has prompted renewed interest in the prevalence and consequences of sexual dysfunctions and compulsive sexual behavior[xi].

Consultation Objectives

The objectives of the present consultation were as follows:

To develop a conceptual framework for the promotion of Sexual Health

To identify Sexual Health concerns and problems in the Region of the Americas

To suggest actions and strategies to achieve and maintain Sexual Health

注 释  NOTES