背景與目的      Background and Objectives

歷史背景   Historical Background

根本原因   Rationale

磋商目標   Consultation Objectives

中文翻譯：彭曉輝（中國 武漢 華中師範大學生命科學學院 430079）完成時間：2006年3月
Translator：Xiaohui Peng (Life Science College of CCNU, Wuhan, 430079, China)
校   對：吳敏倫（中國 香港 香港大學醫學院）完成時間：2006年8月

背景與目的

歷史背景

人類性學教育與性治療大會：1974年2月6日-12日，世界衛生組織(World Health Organization，簡稱WHO)在日內瓦舉行了衛生保健專業人員培訓。應邀出席培訓的學員來自不同的國家，他們在人類性學領域具有教育、研究和臨床專業知識與實踐方面的經驗。大會旨在對下列領域做出重要的評論和提出建議：

在健康專案中性科學的作用，尤其在家庭計畫行為中的作用；

對衛生保健專業的人類性學的教學內容與教學方法；

人類性學的教育與性治療專案的啟動、組織和執行；

性科學領域的參考文獻與合作的國際服務。

認同適合於應對多元社會文化環境優先需求和由一般衛生工作者實踐的治療和諮詢模式；

這次研討會的成果以“人類性學教育與性治療：衛生專業人員的培訓”[i]的文件形式提出了報告。這是一個為衛生保健專業人員提供必需的性教育、性諮詢和性治療的改進培訓鋪平道路的歷史性檔。它也為在全球發展性科學和建立性資訊資源中心起到了激發的作用。

世界衛生組織歐洲部繼而專門針對這個檔的內容舉辦了後續的兩次會議[ii]。可是，這個報告並沒有被廣泛傳播，因此，報告所建議的行動方案並沒有如提議的那樣被廣泛地採納。

自從第一個檔出版25年已經過去了，在人類性學領域和其他相關知識領域已經有了長足的發展。這些個發展豐富和加深了我們對性教育、性諮詢和性治療複雜性的理解和認識。通過研究，已經甄別出哪些方法和干預措施有效，哪些無效。現在出現了新的難題，尤其是出現的了HIV/AIDS的全球流行，讓我們越來越意識到：現時的緊迫需要已經擺在了我們的面前，那就是加強性方面的培訓並更加步調一致和採取更全面的手段對付性健康問題。

為了擴大和豐富早先已經取得的成果，在世界性學會(the World Association for Sexology，簡稱WAS)的協作下，泛美衛生組織(Pan American Health Organization，簡稱PAHO)召集了一個區域磋商會議，為的是重新研究和分析如何促進性健康，其中還研究了衛生保健部門在達到和維持性健康中的任務。本文件就是這次磋商會議的結果。磋商會議於2000年5月19日-22日在瓜地馬拉的安提瓜島舉行。

根本原因

在過去的25年裏，與性健康最為密切的一些領域已經有了相當大的發展。這些發展包括：

人類性學各個方面的知識進展。這種進展是通過理論質詢、生物醫學、心理學、社會學、人類學的研究以及通過流行病學監測與臨床工作而達到的。這些學科及其諸方面的研究為人類性學這個異常複雜的學科領域的發展做出了貢獻。人類性學則超越了上述每一個單獨的學科所涵蓋的範圍。

HIV全球流行的出現和不斷意識到的其他性傳播疾病的衝擊[iii]。這些難題的有效解決有賴於成功地改變人們的各種行為模式和性習慣。所以，促進行為改變的能力高度地倚賴於人們對人類性學的充分理解[iv]。

源自女權主義者的著述和見解的多方面知識體系的形成。這種知識表明社會是由一系列複雜的和無所不在的一系列規則和前提條件所關聯和所調節的，這些規則和前提條件滲透社會的每一個方面並恰好成為這個知識體系的構成部分。這種女權主義者的性別視角已經揭示，如果忽視了“男性特性”與“女性特性”的文化概念，人類性學的任何考量都不可能是完整的[v]。

生殖健康領域的界定和強化。在國際人口與發展大會行動計畫(Program of Action of the International Conference on Population and Development)裏，尤其包括性健康在內的生殖健康被列入優先的考慮範圍[vi]。

重視社會暴力問題，其中包括重視性暴力問題，尤其把針對婦女、兒童和性少數的性暴力視為一個嚴重的公共衛生問題[vii]。

公認性權利作為人權的一部分。世界上有數個國際組織，諸如國際計劃生育聯盟(International Planned Parenthood Federation)[viii]和世界性學會[ix]等，已經明確地承認和聲明瞭性權利。可是，1994年在開羅召開的國際人口與發展大會(International Conference on Population and Development，簡稱ICPD)和1995年在北京召開的第四屆世界婦女大會(the Fourth World Conference on Women)上，性權利常常只在生殖方面獲得了認可[x]。因而，需要採取更全面的理性態度以達到對性權利的完全共識。

越來越多的社會運動呼籲重視、尊重和保護“性少數群體”(諸如男同性戀者、女同性戀者和跨性者)的權利。

研製與改進有效而安全的藥物以調節和改善個人的性功能。這已經促使人們的興趣重新關注於性功能障礙和強迫性行為的流行病學和因果關係的研究^xi。

磋商目標

現時的磋商目標如下：

制定性健康促進的概念框架

鑒別美洲國家區域內的性健康憂慮(Sexual Health concerns)和性健康問題(Sexual Health problems)

提出達到和維持性健康的行動方案和策略建議

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 釋  NOTES