National policy and sexual health of men who have sex with men.

Nurses continue to play a crucial role in helping to deliver the Department of Health's 10-year National Strategy for Sexual Health and HIV (DH, 2001) and the Government's White Paper, Choosing Health (DH, 2004). Both policies aim to reduce the transmission of sexually transmitted infections (STIs) and the prevalence of undiagnosed cases. However, over the past 10-years the rate of newly diagnosed STIs among men who have sex with men (MSM) has increased by 77% (Health Protection Agency, 2007). Genitourinary medicine (GUM) clinics have long been popular with MSM owing to their provision of non-judgemental services, and are increasingly becoming nurse-led. However, the relative underfunding of GUM clinics and the pressures placed on nursing staff to reach waiting time targets has called in to question the quality of service provided. Concurrently, potential contributors to poor sexual health among MSM, including the deep-rooted effects of homophobia and low self-esteem, continue to be overlooked in the fight against rising STIs. Despite the Government's pledge to transform sexual health services with 300 million pounds of extra funding, there has been little significant improvement in the sexual health of MSM. Poor stewardship of resources and poor management of service targets arising from current policy contribute to a negative impact on the sexual health of MSM and the quality and effectiveness of nursing care.