Summary

Twenty-five years ago, articles in this Journal highlighted the lack of resources allocated for family planning services in Britain and also major concerns regarding policies on induced abortion, sexuality and HIV control. Discussions were initiated leading to the creation of a Faculty of Family Planning for advocacy and education as well as to support general reproductive health care. Twenty-five years later, in 2013, there are indications that greater priority in international development will soon be given to sexual health.

Preventing infection

In 1988, 6 years had passed since AIDS had emerged into clinical practice, unfortunately all too often with the label of “the gay plague”. There was hope for control of the HIV epidemic either with a vaccine as had been so effective for the eradication of smallpox, or with antimicrobial therapy as for syphilis, since the quarantine of affected individuals was neither politically nor practically feasible. Malcolm Potts emphasised the crucial role of individual behaviour for the control of the HIV epidemic.1 Taking a historical view, he felt that the introduction of syphilis to Europe by Columbus's crew had played a role in promoting Puritanism, as the fear of syphilis had resulted in stern punishment for sexual immorality, resulting in profound changes in sexual behaviour that had led to a major decrease in illegitimacy. As family planning was “the branch of medicine with the strongest tradition of prevention”, Potts was convinced of its role for HIV control through the promotion of community partnerships and empowerment of individuals for informed choice, instead of “enforced ignorance”. Since “coital expression of sex is regulated by law and restricted by religion” and HIV is “moving more rapidly than bureaucracies can react”, young people needed special attention as they “always take appalling risks out of ignorance or malice”.1

The value of widespread …