· Executive Brief
World Sexual Health Day 2026
Use the observance to align communication, service routes, community partners, measures, and accountable follow-through.
Leadership signal
Recognition becomes useful when leaders inspect the real route.
Leaders can use the campaign window to bring partners around one operating map. Clarify the intended audience, approved message, receiving channels, accountable teams, transition points, and the small set of locally defined signals that will show whether the route worked.
Start by distinguishing what is known from what the organization still needs to learn. A campaign plan, communication volume, or meeting count does not establish that a route is usable. Leaders need direct listening, clear ownership, locally defined measures, and a method for keeping exceptions visible.
Executive opening
Sexual health services succeed or fail at the first offer and the last handoff
World Sexual Health Day gives health systems a reason to treat sexual health as an operating system rather than a campaign. Testing, treatment, partner care, prevention and education run through emergency departments, schools, pharmacies, mail-based services and community clinics. Each setting can widen access or quietly lose people between steps.
The burden is larger than diagnosis counts suggest. A modeling analysis estimated chlamydia prevalence of 4.6% among U.S. women aged 15 to 24 years, with testing coverage of only 33.4%.[10] Across states, estimated chlamydia incidence was 1.9 to 3.1 times as high as observed diagnosis rates.[10] Gonorrhea showed a wider gap, with estimated incidence above diagnosis rates in every state.[10]
Follow-through is weaker still. In three Bronx emergency departments, 547 patients received a new sexually transmitted infection diagnosis during sexual health-related care in 2021 and 2022.[3] Within 12 months, 28% were retested for HIV, 10% discussed PrEP and 1% started it.[3] Detection worked, but linkage to prevention did not.
These findings point to operating choices rather than new clinical science. The sections that follow add peer-reviewed evidence on access routes, school-based education, partner therapy, workforce models, equity and communication. They are written to sit beside the live page’s route, dashboard and 90-day plan, not to replace them. Executives do not need to choose one route. They need to know which doors their population uses, what happens after each test, and who is accountable when a result does not lead to care.
Most of the studies come from U.S. settings, with further evidence from England, Canada and Eswatini. Many are single-site, small or descriptive, so they are best read as signals about where pathways fail rather than as local benchmarks. Local data, stratified by payer, age, race, gender identity and neighborhood, remain the real test of whether services are improving.
Current evidence
The burden is undercounted and screening is uneven
State estimates show how much variation sits beneath national figures. Chlamydia prevalence among women aged 15 to 24 years ranged from 2.3% to 7.8% across states.[10] Gonorrhea prevalence ranged from 0.09% to 1%, and chlamydia incidence ranged from 2.8% to 12.4%.[10] Gonorrhea incidence estimates were 3.3 to 4.7 times as high as diagnosis rates.[10] Diagnosis counts alone therefore understate the infections present in a health system’s population.
Screening in pregnancy comes closer to guideline expectations but is not complete. Among 917,859 privately insured pregnancies from 2016 to 2019, screening coverage was 90.5% for syphilis, 82.4% for HIV, 80.4% for chlamydia and 79.5% for gonorrhea.[8] Trichomoniasis screening, which is recommended on a risk basis, reached 22.4%.[8] Screening was lowest among pregnancies ending in spontaneous abortion and declined with maternal age for chlamydia, gonorrhea and trichomoniasis.[8] Urban and rural differences were small, with slightly higher screening in urban areas.[8]
Routine testing for men who have sex with men also falls short of recommendations. The study covered 81,716 men who have sex with men, or with men and women, seen in U.S. private outpatient settings from 2019 to 2022.[9] Among those without HIV, 55.5% had an HIV test at the first visit.[9] PrEP use was 30.9% and PrEP initiation was 18.1%.[9] Of men tested for chlamydia and gonorrhea, 48% were tested at the genital site only and 25% at all three anatomic sites.[9] Positivity was 9.8% for rectal chlamydia, 7.3% for rectal gonorrhea and 5.3% for pharyngeal gonorrhea.[9] Those results show what genital-only testing can miss.
Emergency departments carry a large share of this work. In the Bronx cohort, 8,035 patients met criteria for sexual health-related care across 330,124 emergency department encounters.[3] Infection prevalence was higher among Black patients, with a prevalence ratio of 1.68, and among patients aged 18 to 29, with a prevalence ratio of 2.26.[3] Prevalence was also higher among cisgender men, with a prevalence ratio of 2.60, and among patients with a prior infection or a substance use diagnosis.[3]
The common thread is that each setting detects only part of the need. Leaders should expect hidden infections where testing coverage is low, and incomplete testing where workflows default to a single site or a single infection.
Figure 1
Sexual health pathways reach many people at one step and few at the next
Percent of the eligible or diagnosed population reaching each step, as reported in each study. Values are copied from the cited studies [3], [8], [10]; none is estimated.
Data note. The bars come from three studies with different populations, years and data sources, so comparison across them is an indirect comparison; only the three Bronx values share one cohort.
Limitation. The screening figures describe insured or modeled populations, while the linkage figures come from one urban emergency department system.
Figure data (5 rows)
| Measure | Value | Population, setting and year as reported | Source |
|---|---|---|---|
| Prenatal chlamydia screening coverage | 80.4% | 917,859 privately insured U.S. pregnancies, 2016 to 2019 | [8] |
| Chlamydia testing coverage, women aged 15 to 24 | 33.4% | Modeled national estimate for U.S. women, calibrated to 2019 to 2023 data | [10] |
| Retested for HIV within 12 months of an STI diagnosis | 28% | Adults with a new STI diagnosis in three Bronx emergency departments, 2021 to 2022 | [3] |
| Discussed PrEP within 12 months of an STI diagnosis | 10% | Same Bronx emergency department cohort | [3] |
| Started PrEP within 12 months of an STI diagnosis | 1% | Same Bronx emergency department cohort | [3] |
Continuum of care
Linkage after a positive test is the weakest step
A diagnosis should open a path to treatment, partner care, retesting and prevention. In the Bronx emergency department cohort, only 36% of patients with a confirmed infection were retested for sexually transmitted infections within 12 months, and one patient acquired HIV.[3] The authors conclude that strengthening linkage to longitudinal care is urgently needed.[3] Only 7% of the 8,035 patients seeking sexual health-related care had a new diagnosis.[3] The cohort tracked prevention outcomes only for those diagnosed, so the prevention opportunity among the rest went unmeasured.[3]
Partner treatment is another handoff that often fails. Expedited partner therapy lets clinicians treat the sexual partners of patients with infections without a clinical visit, yet uptake in emergency departments has been limited.[12] Interviews with 18 emergency department medical directors and key personnel identified perceived legal liability, unclear workflows and electronic health record problems when prescribing for a nonpatient.[12] Facilitators were task sharing, streamlined record processes and leadership support.[12] The interviews followed an implementation research framework and took place from July 2020 through February 2021.[12] Experiences from emergency departments with established protocols suggest these obstacles can be overcome.[12]
Linkage to PrEP can be designed as a service rather than left to chance. At a county sexually transmitted infection clinic in Santa Clara County, pharmacists furnished PrEP without a physician prescription.[5] Navigators handled payment assistance, scheduling and translation.[5] Between 2017 and 2023, 545 patients started PrEP, and 379 (69%) did so after receiving navigation services.[5] Navigation therefore supported most starts, which makes the navigator role a measurable part of the pathway.
Coverage shapes whether people stay connected. Among people with diagnosed HIV in Virginia, Medicaid coverage was 18.9% to 25.4% before Medicaid expansion and 30.1% to 33.9% after it.[11] Testing for gonorrhea, chlamydia and syphilis in the past 12 months was 34.8% after expansion and 27.8% before.[11] The share missing at least one antiretroviral dose in the past 30 days was 29.9% after expansion and 37.6% before.[11]
For executives, the practical message is that each positive result should carry a defined bundle. That bundle includes treatment, partner options, a retest reminder and a prevention conversation, each with a named owner and a way to confirm completion. Without that bundle, a positive test closes as an encounter rather than as a completed episode of care, and no one is accountable for what happens next.
Figure 3
Why the pathway breaks
People
- Teachers unprepared to deliver sexual health education
- Sexual health stigma among patients and staff
- Few navigators to arrange payment assistance and follow-up
Process
- No defined bundle after a positive result
- Unclear expedited partner therapy workflows
- Testing defaults to a single anatomic site
Technology
- Electronic health records cannot prescribe for a nonpatient
- No retest or PrEP prompts after diagnosis
- Clinic websites silent on inclusion and integrated care
Environment
- Distance to services and preference for nearby clinics
- Lower self-sampling use in deprived areas
- Privacy and confidentiality concerns among young people
Policy
- Perceived legal liability for partner therapy
- Coverage and cost barriers
- Exclusion of students with disabilities from school-based education
Measurement
- Diagnosis counts that understate incidence
- Linkage to PrEP not tracked after emergency visits
- Testing not stratified by deprivation, identity or disability
Unranked qualitative cause-and-effect diagram for the outcome in the box: People with sexual health needs are not tested, treated, offered partner therapy or linked to prevention Causes are assembled from the cited literature [3], [4], [6], [7], [9], [10], [11], [12], [13], [14], [15]; categories are not weighted and their order carries no meaning.
Data note. Qualitative; no frequencies are implied.
Limitation. Causes drawn from published studies may not all apply locally; validate them with frontline teams.
Figure data (6 rows)
| Category | Causes drawn from the cited literature |
|---|---|
| People | Teachers unprepared to deliver sexual health education; Sexual health stigma among patients and staff; Few navigators to arrange payment assistance and follow-up |
| Process | No defined bundle after a positive result; Unclear expedited partner therapy workflows; Testing defaults to a single anatomic site |
| Technology | Electronic health records cannot prescribe for a nonpatient; No retest or PrEP prompts after diagnosis; Clinic websites silent on inclusion and integrated care |
| Environment | Distance to services and preference for nearby clinics; Lower self-sampling use in deprived areas; Privacy and confidentiality concerns among young people |
| Policy | Perceived legal liability for partner therapy; Coverage and cost barriers; Exclusion of students with disabilities from school-based education |
| Measurement | Diagnosis counts that understate incidence; Linkage to PrEP not tracked after emergency visits; Testing not stratified by deprivation, identity or disability |
Access
Access widens when services meet people where they already are
Mail-based testing has changed access in England. Across three areas that introduced online postal self-sampling, chlamydia and gonorrhea testing in 2022 was 2.1 to 2.5 times the earlier baseline.[4] The three areas used different models and served different populations, and testing rose in all of them.[4] HIV testing ranged from 1.5 to 2.8 times baseline.[4] In one area, the largest relative increase occurred among women, with an incidence rate ratio of 3.2.[4]
Community preferences favor nearby and familiar settings. A North Dallas assessment surveyed 100 people from priority populations about where they would seek care.[13] Most said they would feel comfortable using sexual health services in a medical building (95%) or a mobile clinic (91%).[13] Comfort was lower for an office building, at 76%, or a pharmacy, at 74%, and half preferred a closer clinic.[13] Lack of awareness of services was the primary barrier, cited by 57%.[13]
Acute care settings can add testing without adding much clinician time. A randomized trial at an urban academic medical center tested a smartphone decision aid for adolescents and young adults aged 14 to 24.[1] The trial randomized 44 clinicians and enrolled 139 participants.[1] The tool, built through human-centered design, gave personalized testing recommendations and values clarification exercises.[1] Participants in the decision aid arm were 1.76 times more likely to receive gonorrhea and chlamydia testing and 4.56 times more likely to receive pharyngeal testing.[1]
Youth-focused clinics show similar promise. A brief digital storytelling intervention was tested with 100 adolescents and young adults at a youth-focused clinic in Southeast Michigan.[2] At 6 months, HIV testing was 52% with the intervention versus 12% with usual care, and infection testing was 52% versus 20.4%.[2] The authors call for larger trials to confirm these pilot results.[2]
Taken together, these studies suggest that access improves when testing is offered through several doors at once. Mail, mobile units, emergency departments and youth clinics each reach people the others miss. Each door also needs a clear route from a positive result to treatment, which mail and digital services must plan as carefully as clinics do. Leaders should know how many tests arrive through each door and what share of positive results from each door reach treatment.
Executive guidance · System route
Map the path from first contact to verified follow-through.
Use this route as a discussion framework. Replace each stage with the organization’s approved process, qualified roles, current service capacity, and applicable requirements. Do not infer a clinical protocol from the observance title.
The route at a glance
- Define the purpose
- Align the entry point
- Coordinate the partner route
- Manage response
- Review the campaign
Reliability rule: Every stage needs a named owner, an observable status, an approved escalation path, and a defined signal that shows whether responsibility moved or remained unresolved.
Define the purpose
Name the audience, intended action, approved message, and limits of what the campaign can responsibly promise.
Align the entry point
Connect every communication channel to current information and a clearly identified receiving role or team.
Coordinate the partner route
Align internal teams and external partners around one current message, real entry point, receiving owner, escalation path, and follow-through signal.
Manage response
Keep questions, referrals, exceptions, and unresolved work visible until an accountable receiver accepts them.
Review the campaign
Compare intended action with local process signals and partner feedback, then document the improvement to carry forward.
Figure 2
The system route as one flow
The five stages of the system route described in this brief, drawn as one flow with a learning loop back to the start. The stages are the page’s original executive guidance, not a clinical protocol.
Data note. Shows sequence and handoffs only; it carries no counts or rates.
Limitation. Local processes may add, merge or reorder stages under organizational policy.
Figure data (5 rows)
| Stage | What the stage requires |
|---|---|
| Define the purpose | Name the audience, intended action, approved message, and limits of what the campaign can responsibly promise. |
| Align the entry point | Connect every communication channel to current information and a clearly identified receiving role or team. |
| Coordinate the partner route | Align internal teams and external partners around one current message, real entry point, receiving owner, escalation path, and follow-through signal. |
| Manage response | Keep questions, referrals, exceptions, and unresolved work visible until an accountable receiver accepts them. |
| Review the campaign | Compare intended action with local process signals and partner feedback, then document the improvement to carry forward. |
Equity and trust
Equity gaps follow deprivation, identity, disability and awareness
New routes can widen gaps if no one watches who uses them. In England, the most deprived areas had the lowest relative increase in chlamydia and gonorrhea testing after self-sampling began, at 1.9 to 2.1.[4] The authors note that not everyone who needs testing is aware of self-sampling or has the confidence and ability to use it.[4] They recommend keeping a choice of testing mode for service users.[4]
Trans and gender diverse patients often cannot tell from public information whether a service is safe for them. An environmental scan reviewed 198 HIV and sexually transmitted and blood-borne infection clinic websites in Ontario in 2024.[7] Of these, 55.1% showed visual or textual inclusion of trans and gender diverse people.[7] Only 21.7% described nonmedical affirmation programming, and 10.6% endorsed integrated prevention, care and gender-affirming health care.[7]
Knowledge of prevention options is uneven. In the North Dallas assessment, interest in PrEP was 24%, interest in nonoccupational postexposure prophylaxis was 4% and interest in doxycycline postexposure prophylaxis was 3%.[13] The authors read those figures as a sign of low knowledge about these options.[13] Black respondents felt more comfortable than Latinx respondents discussing sexual health with peers, partners and health care providers.[13] In the Bronx cohort, higher infection prevalence among Black patients makes emergency department linkage gaps an equity problem as well as a quality problem.[3]
Disability is a frequently missed equity dimension. Students with intellectual and developmental disabilities are often excluded from school-based sexual health education despite the need and benefits.[14] Researchers held focus groups with 19 special education teachers and interviews with 7 health education teachers.[14] They identified misbeliefs and stigma, uneven support from parents and administrators, limited teacher preparedness and a lack of suitable curricula.[14]
Coverage remains a structural lever. The Virginia authors suggest that expanding health care coverage options that decrease cost barriers may support screening among people with HIV.[11] Equity review should therefore track payer, deprivation, identity and disability alongside race and age. Each dimension needs a protected, locally appropriate review process and community partners who can explain what the numbers miss. Websites, intake forms and referral scripts are practical places to start, because they shape whether people believe a service is meant for them.
Human infrastructure
Pharmacists, navigators, teachers and emergency teams carry the work
Pharmacist-led models can extend prevention capacity. The Santa Clara authors note that primary care providers are increasingly trained to prescribe PrEP, yet patients still struggle to discuss it comfortably and confidentially with them.[5] In the pharmacist model, 61% of patients who started PrEP identified as Hispanic or Latino, 97% identified as male and 72% were aged 25 to 44.[5] Navigators also scheduled initial and quarterly follow-up appointments.[5] The authors describe the clinic as a safety-net access point for priority populations.[5]
Emergency teams need operational support to deliver partner therapy. Leaders interviewed about expedited partner therapy cited ambiguity about duty to the sexual partner, patient safety concerns and sexual health stigma as barriers.[12] They emphasized the emergency department’s potential to expand access for people at high risk, provided that partner therapy did not disrupt clinical operations.[12] Task sharing and leadership support were the clearest enablers.[12]
Teachers are part of the sexual health workforce. In the U.S. Southwest, 31 recent high school graduates said the individuals who teach sexual health education are critically important.[15] They described current instruction as not helpful and sometimes harmful.[15] The authors recommend teacher training and the inclusion of youth as stakeholders in planning and evaluation.[15]
Preparation gaps are sharper for specialized classrooms. Teachers of students with intellectual and developmental disabilities identified teacher preparedness as one of four main barriers.[14] They also cited a lack of evidence-based curricula and materials for their students.[14] Their recommendations span student, interpersonal, community, institutional and policy levels.[14]
Digital tools can relieve some of the load on clinicians. Clinicians and patients in the emergency department trial rated the decision aid as acceptable, appropriate and feasible for routine workflows.[1] Health systems that partner with schools and community clinics can share training, referral routes and data agreements rather than building each one separately. The Michigan pilot used a community-engaged research approach, a model for designing tools with the people who will use them.[2] Workforce plans should count pharmacists, navigators, school nurses and health educators explicitly and assign training budgets to each. Leaders should also decide who owns the school and community partnerships, since those relationships often depend on one committed individual.
Executive guidance · Operating dashboard
Measure whether the operating route works as intended.
Do not publish a number until the organization defines its numerator, denominator where relevant, owner, source system, exclusions, review cadence, and limits. The candidates below are management prompts, not benchmarks or reported results.
Four operating signals
Each signal pairs an executive question with one candidate local measure, set out below.
Executive guidance · Signal
Message alignment
Do channels and partners communicate one current and appropriately bounded route?
- Candidate local measure
- Content review status, conflicting instructions, corrections, and unresolved questions.
Executive guidance · Signal
Response ownership
Does every campaign-generated request reach an accountable receiver?
- Candidate local measure
- Routing, acknowledgment, repeat contact, unresolved work, and escalation signals.
Executive guidance · Signal
Partner-route reliability
Do participating teams share one current route and understand who owns each dependency?
- Candidate local measure
- Locally defined conflicting instructions, unaccepted handoffs, unresolved dependencies, repeat contacts, and partner feedback.
Executive guidance · Signal
Action closure
Did leaders complete and verify the improvement selected for the campaign window?
- Candidate local measure
- Assigned action, status, evidence of completion, and post-action review.
Figure 4
The operating system behind the dashboard
The four operating signals from this brief’s dashboard, each tied to the candidate owner named in the executive scorecard, around one accountable route. Drawn from the page’s original executive guidance.
Data note. Structural diagram; no measured values.
Limitation. Owners are candidates to be confirmed locally.
Figure data (4 rows)
| Operating signal | Candidate owner |
|---|---|
| Message alignment | Executive sponsor and operational lead |
| Response ownership | Operational owner and participating teams |
| Partner-route reliability | Sending and receiving owners |
| Action closure | Improvement owner and executive sponsor |
Executive guidance · Handoff workflow
Keep work owned when it crosses a boundary.
A handoff is reliable only when the sending party knows who is expected to receive the work, the receiving party acknowledges responsibility, and any unresolved exception remains visible. Local policy and qualified judgment control the actual process.
How responsibility moves
Lane A
From message to accepted ownership
- Confirm the approved message and intended audience.
- Publish the actual entry point and receiving role.
- Acknowledge receipt using the locally approved method.
- Escalate when ownership or response remains unclear.
Lane B
From accepted ownership to verified follow-through
- Record the next accountable owner and visible status.
- Name the sending and receiving owners, shared information, current status, and unresolved dependency.
- Keep unresolved work visible across boundaries.
- Confirm closure or document the continuing exception.
Executive guidance · Executive scorecard
Ask questions that connect intent, ownership, and results.
The scorecard keeps review focused on decisions. Leaders should set definitions locally, examine variation without overclaiming cause, and pair quantitative signals with the experience of people who use and operate the route.
Who reviews what
- Executive sponsor and operational lead
- Operational owner and participating teams
- Sending and receiving owners
- Improvement owner and executive sponsor
Candidate owners named in the scorecard, confirmed locally.
| Operating signal | Executive question | Candidate owner | Suggested review point |
|---|---|---|---|
| Message alignment | Do channels and partners communicate one current and appropriately bounded route? | Executive sponsor and operational lead | At campaign launch and close |
| Response ownership | Does every campaign-generated request reach an accountable receiver? | Operational owner and participating teams | At a locally defined cadence |
| Partner-route reliability | Do participating teams share one current route and understand who owns each dependency? | Sending and receiving owners | At a locally defined cadence |
| Action closure | Did leaders complete and verify the improvement selected for the campaign window? | Improvement owner and executive sponsor | Until action is verified |
Figure 5
Control points for reliable sexual health services
| Control point | Risk if missing | Owner | Evidence of control |
|---|---|---|---|
| Defined bundle after every positive result: treatment, partner options, retest reminder and prevention offer | Patients are treated once and lost before retesting or PrEP | Emergency and ambulatory medical directors | Share of positive results with each bundle element documented |
| Expedited partner therapy workflow with electronic health record support | Partners go untreated and reinfection follows | Emergency department medical director with informatics lead | Share of eligible diagnoses with partner therapy offered |
| Navigation and pharmacist PrEP pathway | Prevention depends on whether a busy prescriber starts the conversation | Pharmacy director and prevention program manager | PrEP starts after navigation and on-time quarterly follow-up |
| Multiple testing doors, including mail, mobile and youth clinic options | Groups who avoid clinics remain untested | Ambulatory access lead | Testing volume by route and population |
| Stratified review of self-sampling and clinic testing use | New routes widen gaps for deprived communities | Health equity officer with analytics | Quarterly report by deprivation, payer, race, age and gender identity |
| Accurate public information on services, cost, privacy and inclusion | People do not know services exist or whether they are welcome | Marketing and community engagement lead | Annual audit of web and community listings |
Control points derived from the cited evidence [1], [3], [4], [5], [7], [12], [13] and this brief’s executive guidance.
Data note. Each row is a control to verify, not a measured result.
Limitation. Owners and evidence of control must follow local policy and applicable requirements.
Public communication
Confidentiality and plain information decide whether people come forward
Confidentiality is a precondition for access, especially for young people. Young people seeking sexual and reproductive health services in Manzini, Eswatini, named low health literacy, stigma, privacy and confidentiality as barriers.[6] The 14 participants, aged 10 to 24, identified community outreach and health education as the main enablers.[6] They were recruited at a Family Life Association clinic, and the authors saw the existing health system as an opportunity to deliver information and services.[6] Privacy protections need to be visible to young people before they arrive, not explained only once they are in the room.
Young people also want clear information earlier. Recent graduates in the U.S. Southwest said they wanted and needed sexual health education taught in school.[15] Youth voices can guide which topics schools and clinics explain, and how.[15] Because graduates found current instruction sometimes harmful, the quality of the message matters as much as its presence.[15] Teachers of students with disabilities add that parents, caregivers and administrators shape what students are allowed to hear.[14]
Communication inside the visit matters as much as public messaging. Participants who used the emergency department decision aid reported greater clarity about testing options and higher satisfaction with their care.[1] In the Michigan pilot, both youth and providers in the digital storytelling group reported better clinician-youth communication than controls.[2] These tools help patients ask for testing without having to start an uncomfortable conversation. They also give clinicians a consistent starting point, which matters when visits are short and busy.
Public information is often the first signal of welcome or exclusion. The Ontario website scan shows that many clinics do not say whether they serve trans and gender diverse people or offer integrated care.[7] In North Dallas, lack of awareness of existing services was the leading barrier to care.[13] Clear, current web and community information about where to test, what it costs and how privacy is protected is a low-cost fix. Low interest in PrEP and postexposure prophylaxis in North Dallas suggests that messages should explain what these options are before asking people to use them.[13]
Messages should be plain, local and consistent across channels. Systems can test them with the communities they serve, publish one accurate list of testing options, and review whether awareness and use change after each campaign window.
Executive guidance · 90-day plan
Move from listening to a verified improvement in 90 days.
The time boxes below are a management framework, not a clinical timeline. Adjust them to risk, scope, governance, resources, stakeholder participation, and applicable review requirements.
Ninety days, three moves
- Days 1–30See the current route
- Days 31–60Build the reliable path
- Days 61–90Make the change visible
Days 1–30 · Listen and map
See the current route
- Name an executive sponsor and an operational owner.
- Listen to people using the route and representative frontline teams.
- Map how World Sexual Health Day communications connect to real entry points, owners, transitions, and escalation.
- Select one recurring barrier that the organization can responsibly address.
Days 31–60 · Design and test
Build the reliable path
- Define the trigger, receiving owner, required information, acknowledgment, escalation, and closure signal.
- Validate the design with every sending and receiving team involved.
- Test one internal or partner handoff and correct a verified communication, dependency, or ownership gap.
- Test the route in more than one representative setting or operating period where practical.
Days 61–90 · Implement and verify
Make the change visible
- Launch the redesigned route with a small set of locally defined measures.
- Review unresolved work and recurring friction using a learning approach.
- Correct implementation barriers and record who owns each remaining dependency.
- Report what changed, what evidence was reviewed, and what still requires live oversight.
Figure 6
The 90-day plan on one timeline
The 90-day plan from this brief drawn as a timeline: each action sits in the 30-day window the plan assigns it. The full wording of each action is in the figure data and in the plan above.
Data note. Time boxes are a management framework, not a clinical timeline.
Limitation. Durations are uniform 30-day windows; real tasks may span windows.
Figure data (12 rows)
| Window | Action |
|---|---|
| Days 1–30 · Listen and map | Name an executive sponsor and an operational owner. |
| Days 1–30 · Listen and map | Listen to people using the route and representative frontline teams. |
| Days 1–30 · Listen and map | Map how World Sexual Health Day communications connect to real entry points, owners, transitions, and escalation. |
| Days 1–30 · Listen and map | Select one recurring barrier that the organization can responsibly address. |
| Days 31–60 · Design and test | Define the trigger, receiving owner, required information, acknowledgment, escalation, and closure signal. |
| Days 31–60 · Design and test | Validate the design with every sending and receiving team involved. |
| Days 31–60 · Design and test | Test one internal or partner handoff and correct a verified communication, dependency, or ownership gap. |
| Days 31–60 · Design and test | Test the route in more than one representative setting or operating period where practical. |
| Days 61–90 · Implement and verify | Launch the redesigned route with a small set of locally defined measures. |
| Days 61–90 · Implement and verify | Review unresolved work and recurring friction using a learning approach. |
| Days 61–90 · Implement and verify | Correct implementation barriers and record who owns each remaining dependency. |
| Days 61–90 · Implement and verify | Report what changed, what evidence was reviewed, and what still requires live oversight. |
Executive guidance · Leadership close
Carry one accountable improvement beyond the campaign window.
Recognition matters. It becomes durable when leaders also listen, clarify the route, support the people operating it, close an identified gap, and report the result without claiming more than the evidence supports.
Leadership commitment
Listen to the people closest to the route, assign one barrier, and verify the change.
Executive action kit · Day observance
Turn World Sexual Health Day into accountable action.
Use the observance to align communication, service routes, community partners, measures, and accountable follow-through.
Leadership focus
Use this observance to examine trustworthy information, prevention access, and community connection. Select one verified barrier, assign an accountable owner, and carry the improvement beyond the campaign window.
Workforce lens
Ask whether staffing, role clarity, training, tools, workload, and escalation support the people operating the information, access, coordination, and follow-through pathway.
Patient and community lens
Make the approved first step clear. Test whether a person can move from information to an acknowledged next action without navigating conflicting instructions.
Equity and access lens
Review language, disability, transportation, digital access, geography, trust, and other barriers using protected feedback and locally appropriate data.
Five-minute briefing
Inspect the operating sequence
Listen with people using the pathway, frontline teams, operational leaders, and community partners. Find one a message, request, referral, or handoff that does not reach an accountable owner, then test the locally approved route from entry through acknowledged follow-through.
- Define the purpose
- Align the entry point
- Coordinate the partner route
- Manage response
- Review the campaign
Leadership actions for this week
- Name an executive sponsor and frontline operating owner.
- Ask people using and operating the pathway where ownership becomes unclear.
- Test one representative route from first question to acknowledged next step.
- Select one barrier that can be corrected without overstating the evidence.
- Set a review date and define how completion will be verified.
Candidate measures
Define every numerator, denominator where relevant, owner, data source, exclusions, cadence, and limitation locally. These are management prompts, not external benchmarks.
- Content review status, conflicting instructions, corrections, and unresolved questions.
- Routing, acknowledgment, repeat contact, unresolved work, and escalation signals.
- Locally defined conflicting instructions, unaccepted handoffs, unresolved dependencies, repeat contacts, and partner feedback.
Department readiness checklist
- The public and staff entry points match the actual approved process.
- A specific role accepts each request, referral, or escalation.
- Handoffs include acknowledgment and a visible unresolved state.
- Language, disability, digital, transportation, and trust barriers receive explicit review.
- Communications do not introduce unsupported themes, statistics, or clinical advice.
- A named leader will review what changed after the observance.
Intended audiences
- Executive and Operational Leaders
- Public Health and Community Partners
Staff communication template
During World Sexual Health Day, our organization will connect awareness with a practical review of the information, access, coordination, and follow-through pathway. Use approved information, identify the correct entry point, confirm ownership when work moves, protect privacy, and escalate unresolved barriers through local channels.
Community communication template
World Sexual Health Day is an opportunity to share trustworthy information and make the next step easier to find. Use our approved channels for information and support. If a request changes hands, our goal is to keep ownership and follow-through visible.
Measurement worksheet
- Signal
- What observable condition will show whether the route works?
- Definition
- What is included, excluded, and counted?
- Owner
- Who reviews the signal and acts on exceptions?
- Cadence
- When will leaders review it?
- Equity check
- Which differences require protected, locally appropriate review?
- Closure
- What evidence will confirm the improvement was completed?
- Editorial review
- Completed
- Source records
- 2 listed under Authoritative resources
- Review standard
- Sourced facts remain separated from original executive guidance
- Clinical boundary
- No new statistical or clinical claim was added by this action kit
Sources and content boundary
Authoritative resources
Use note: All operating models, measures, scorecard questions, and action steps are original executive guidance. This article supports leadership planning and education. It does not replace clinical judgment, emergency procedures, legal advice, professional standards, organizational policy, or applicable federal, state, and local requirements.
Peer-reviewed references
References
Fifteen peer-reviewed sources, newest first. Each was individually verified through authenticated academic research databases. Bracketed numbers in the text link here; the original executive guidance on this page carries no citations because it is guidance, not a sourced claim. Sources last checked in those databases on .
- 1.Chernick LS, Adler T, De Souza J, Franqui CN, Tchoungui LP, Huang S, et al. A Randomized Controlled Trial of a Digital Patient Decision Tool to Increase Sexually Transmitted Infection Testing in the Emergency Department. Annals of Emergency Medicine. 2026;88(2):213-222. https://doi.org/10.1016/j.annemergmed.2026.03.016
- 2.Cordova D, Bauermeister JA, Warner S, Jiang Z, Mendoza Lua F, Khreizat S, et al. Pilot Study of a Digital Health Intervention to Increase HIV and Sexually Transmitted Infection Testing Uptake and Reduce Condomless Sex and Substance Use Among Adolescents. Journal of Adolescent Health. 2026;78(3):485-494. https://doi.org/10.1016/j.jadohealth.2025.05.017
- 3.Andrade EA, Patel VV, Yangga P, Deng Y, Zhang C, Friedman BW, et al. Longitudinal Analysis of Sexually Transmitted Infection and Human Immunodeficiency Virus Prevention Outcomes Among Emergency Department Patients Seeking Sexual Health-Related Care: A Retrospective Cohort Study. Sexually Transmitted Diseases. 2026;53(7):450-457. https://doi.org/10.1097/olq.0000000000002319
- 4.Gibbs J, Stirrup O, Tostevin A, Howarth A, Dewsnap C, Ross JDC, et al. Sexually transmitted infection testing and key outcomes following implementation of online postal self-sampling into sexual health services in England: a retrospective observational study of routinely collected service-level healthcare data. The Lancet Regional Health - Europe. 2026;61. https://doi.org/10.1016/j.lanepe.2025.101541
- 5.Agroia H, Mousli L. Evaluation of an HIV pre-exposure prophylaxis navigation and pharmacist-delivered clinical services model implemented at a municipal sexually transmitted infections clinic, 2017-2023. Journal of the American Pharmacists Association. 2026;66(3). https://doi.org/10.1016/j.japh.2026.103064
- 6.Fakudze S, Mmusi-Phetoe RM. Young people’s perceptions of access to sexual and reproductive health services in Manzini, Eswatini: a qualitative study. African Journal of Reproductive Health. 2026;30(4):13-21. https://doi.org/10.29063/ajrh2026/v30i4.2
- 7.Inaganti A, Underhill A, Lacombe-Duncan A, Soud R, Loutfy M. Assessing Availability of HIV/Sexually Transmitted and Blood-Borne Infection Prevention and Care Services for Trans Women and Gender Diverse People in Ontario, Canada: An Environmental Scan of Clinic Websites. Journal of the Association of Nurses in AIDS Care. 2026;37(2):192-202. https://doi.org/10.1097/jnc.0000000000000609
- 8.Seshu U, Azqul M, Agbese E, Risher K, Leslie DL, Pinto CN. Screening for Sexually Transmitted Infections during pregnancy: Is healthcare meeting expectations?. Sexually Transmitted Diseases. 2026. https://doi.org/10.1097/olq.0000000000002412
- 9.Tao G, Patel CG, He L, Workowski K. Sexually Transmitted Infection (STI)/HIV Testing, STIs, and HIV Pre-exposure Prophylaxis Use Among Men Who Have Sex With Men and Men Who Have Sex With Men and Women in the United States, 2019–2022. Clinical Infectious Diseases. 2026;82(2):e380-e386. https://doi.org/10.1093/cid/ciae314
- 10.Rönn MM, Gift TL, Bronsard M, Tao G, Salomon JA. Estimating State-Level Chlamydia and Gonorrhea Incidence and Prevalence Among Women in the United States, 2019–2023: Mathematical Modeling Analysis. Open Forum Infectious Diseases. 2026;13(9):1-11. https://doi.org/10.1093/ofid/ofag567
- 11.McManus KA, Shields G, Scott K, Kienzle J. Changes in health care coverage and sexually transmitted infection testing following expansion of health care coverage options among people with diagnosed HIV – Medical Monitoring Project, Virginia, 2015–2022. AIDS Care. 2026:1-13. https://doi.org/10.1080/09540121.2026.2697991
- 12.Solnick RE, Cortes R, Chang E, Dudas P, Cetkovic A, Londoño-Barreras R, et al. Barriers to and Facilitators of Expedited Partner Therapy in US Emergency Departments: A Qualitative Study. Public Health Reports. 2026:333549261432089. https://doi.org/10.1177/00333549261432089
- 13.Beckman DA, Gonzalez E, Coleman B, Chow JY. Low Knowledge, Awareness, and Availability of Sexual Health Services: An Assessment of a Diverse North Dallas Community. Sexually Transmitted Diseases. 2025;52(8):475-481. https://doi.org/10.1097/olq.0000000000002149
- 14.Greene A, Simić Stanojević I, Sherwood-Laughlin C, Sangmo D, Baugh M, Greathouse L, et al. Teachers’ Perceptions of Barriers to Implementing School-Based Sexual Health Education for Students with Intellectual and Developmental Disabilities. American Journal of Sexuality Education. 2025;20(4):536-558. https://doi.org/10.1080/15546128.2024.2429432
- 15.Dickson E, Rishel Brakey H, Wilson P, Hackett JM, McWethy M. Classroom Voices: Youth Perspectives to Direct School-Based Sexual Health Education. Sex Education: Sexuality, Society and Learning. 2024;24(4):479-496. https://doi.org/10.1080/14681811.2023.2218267
Claim-to-source matrix
What each source supports
Every sourced claim in the new sections maps to the references that support it, the section where it is used, and the limitation a reader should keep in mind. Original executive guidance carries no sources because it is guidance, not a finding.
| Claim group | Sources | Years | Used in | Limitation |
|---|---|---|---|---|
| Undercounted chlamydia and gonorrhea burden and low testing coverage among young women | [10] | 2026 | Current evidence | Modeled estimates calibrated to pooled 2019 to 2023 data; uncertainty varies by state. |
| Prenatal and routine testing coverage against guidelines | [8] [9] | 2026 | Current evidence | Commercially insured populations only; claims data cannot capture clinical context or uninsured patients. |
| Emergency department detection and weak linkage to retesting and PrEP | [3] | 2026 | Continuum of care | Retrospective cohort from three emergency departments in one city; follow-up limited to the same health system. |
| Expedited partner therapy barriers and facilitators | [12] | 2026 | Continuum of care | Qualitative interviews with 18 leaders from interested institutions, conducted in 2020 and 2021. |
| Pharmacist-delivered PrEP with navigation | [5] | 2026 | Human infrastructure | Single safety-net clinic program evaluation without a comparison group; mostly male patients. |
| Coverage expansion and testing among people with HIV | [11] | 2026 | Continuum of care | Pre-post comparison of weighted survey data; associations, not causal effects. |
| Mail-based, digital and community access routes | [4] [1] [2] [13] | 2026, 2025 | Access | Observational service data in England; small trials and a pilot; purposive community sample of 100. |
| Equity gaps by deprivation, gender identity and disability | [4] [7] [14] | 2026, 2025 | Equity and trust | Website scan measures stated inclusion, not actual practice; teacher findings are qualitative. |
| Confidentiality, youth voice and school-based education | [6] [15] | 2026, 2024 | Public communication | Small qualitative samples in Eswatini and one U.S. state. |
About the author
Greg Wahlstrom
MBAHCM
President and Chief Executive Officer, The Healthcare Executive
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