ABSTRACT

The College of Sexual and Relationship Therapists (COSRT) trains both medical professionals and counsellors. COSRT counsellors have many skills, but mainly use behavioural therapy based on sensate focus, a term usually associated with a set of specific sexual exercises for couples but sometimes for individuals. The chapter highlights the areas in which sexual problems are most prevalent. For centuries, populations have believed that certain substances have aphrodisiac properties, enhancing both sexual desire and performance. Sex workers also have a role helping their clients, mainly men, with sexual difficulties, and they can adapt to the need for fetishes and other ritual behaviours often not tolerated within other relationships. Once a sexual problem has been disclosed in general practice then it is up to doctor or nurse to decide how to manage it. The hopes or fears of people with HIV or recurrent herpes must be discussed in terms of sexual activity, and these conditions in particular can provoke sexual problems post-diagnosis.