Tine M. Gammeltoft and Nguyen Thu Hu-o-ng
Introduction
Over recent decades, the importance of sexual health for global public health has achieved increasing recognition internationally. When sexual health is discussed, the HIV/AIDS pandemic often takes centre stage, but a range of other human predicaments is at issue as well. In an early formulation, a World Health Organisation (WHO) expert group defined sexual health as encompassing ‘the integration of the somatic, emotional, intellectual and social aspects of sexual being in ways that are positively enriching and that enhance personality, communication and love’ (WHO 1975). Besides HIV/AIDS, prevalent sexual health problems include other sexually transmitted infections (STIs) (and their sequelae such as infertility and genital cancers), reproductive tract infections, sexual dysfunction, the physical and psychological consequences of sexual violence, and discrimination on the basis of sexual orientation.
This chapter focuses on sexual health in Vietnam. We begin from the assumption that in Vietnam and beyond, sexual health is a significant political issue. As Foucault (1990) has pointed out, human sexuality cannot be considered apart from the workings of power in society. In Vietnam, present-day political ideologies tap into revitalised Confucian moralities which emphasise social duty, sexual loyalty, and orderly family relations, thereby intertwining late socialist rule with long-standing moral values and orientations (Werner 2009; Leshkowich 2012: 497—526). This ideological emphasis on the family as the cornerstone of society, we argue, has sexual health consequences: by ignoring or condemning sexual practices that do not fit political ideals of sexuality as institutionalised procreative heterosexuality, social authorities unwittingly end up contributing to the country’s burden of sexual ill-health.
In this chapter, we first describe the divisions that are drawn in official discourse between acceptable and non-acceptable forms of sex, the former being politically celebrated, the latter pushed to the margins of society. We then go on to discuss the sexual health consequences of these political divisions, focusing particularly on the silence about sexual violence; the moral condemnation of premarital sex; and the stigmatisation of commercial sex (on official attitudes to same-sex practices and their social consequences, see Newton in this volume). Finally, we conclude by considering the social impact of civil society movements which question the ideological dominance of marriage-and-the-family, pointing to the need for social and political recognition of alternative forms of intimacy and sociality.