Structural Impediments to Sexual Health in New Zealand: Key Informant Perspectives

New Zealand’s bacterial sexually transmitted infection (STI) rates are considered the worst in the OECD. Policy within New Zealand (NZ), as in many Western countries, often takes a particularly individualistic approach to reducing STI rates, but this has proved unsuccessful. This paper presents a thematic analysis of interview data from 32 key informants working in sexual health in NZ, talking about sexual health problems and solutions. Focusing typically on structural explanations, informants identified a large gap between ‘best practice’ and actual practice in NZ. They referred to the interaction between a lack of government prioritisation and a ‘sexually conservative’ culture in New Zealand as lying at the heart of this. Informants advocated for a long-term programme of government leadership and a cultural ‘shift’ in approaches to, and research on, sexual health. To do so, key informants consistently constructed an account of ‘competing rationalities’—or the notion that policy makers, and those that work in the ‘frontline’ of sexual health are operating within two opposing paradigms, and that the ‘culture of conservatism’ they described was limiting dialogue between the two ‘sides’.