Sexuality and Health - Essay Example

?Sexuality and Health Introduction A community nurse in Worcestershire narrated at a Royal College of Nursing conference how she assisted a severely disabled patient in addressing his sexual frustrations by buying an artificial vagina for the patient. Due to the lack of guidelines regarding the sexual needs of physically disabled patients, the nurse consulted the parents of the patient due to the sensitivity of the issue and its legal implications. As a result of the experience, she and her colleagues had to develop a sexual health policy for the local Primary Care Trust (The Independent 2008). In a similar incident, a patient suffering from muscular dystrophy made requests to hospice staff to find a prostitute for him. Upon realising that he won’t be able to have sex anytime soon due to his condition, the patient decided to elicit assistance from the staff regarding procuring the services of a prostitute. In response, the request was escalated to the hospice ethics committee, as well as the legal department (The Independent 2008). Gorin and Arnold (2006) described the complex relationship between human sexuality and health. The term sexual health encompasses a number of phenomena mainly focusing on the health-related outcomes of sexual behaviour. A common perception regarding sexual health is that it is a quality or capability of an individual to avoid committing sexual acts which produce negative consequences such as the spread of diseases or unwanted pregnancies. According to the World Health Organization (WHO), the term sexual health is defined as a state of physical, emotional, mental, and social well-being in relation to sexuality, not just confined to the absence of disease, disability, or affliction. As such, sexual health should be positively viewed as a way of ensuring that individuals are able to create and maintain safe and pleasurable sexual experiences. In addition, sexual health advocates that a person’s sexual rights should be respected, protected, and fulfilled (Gorin & Arnold 2006). Healey and Zimmerman (2010) described the term disability as a frequently used term to denote an individual’s inability to perform tasks which are attainable for a normal human being. However, its definition depends on how it is used. For example, in terms of public health, disability may be perceived on how it affects the general population. In contrast, disability in the public welfare viewpoint may be seen in terms of the provision of services for persons with disabilities. For reasons of clarity, the following terms – impairment, disability, and handicap – are defined as per WHO guidelines. Impairment is defined as a physiological disorder or injury. On the other hand, having a disability is being unable to do a task due to one’s impairment. Meanwhile, possessing a handicap is a social result of being disabled (Healey & Zimmerman 2010). 1.0 The role of health promotion Kirch (2008) maintained that there is no standard definition of the term health promotion and its definition would depend on the activity it is attributed to. As a generalized term however, health promotion is defined as a process or activity with the aim of encouraging people to take action regarding personal health behaviour and compliance to existing health policies and programs. There are four main components of individual health, three of which involves health promotion. These components are: (1) lifestyle and behaviour; (2) health, social, and other service provision; and (3) socio-economic and physical environment. In relation to the determination of health, health promotion encompasses activities which encourage individuals to act on certain internal and external aspects which influence overall health. Internal aspects refer to determinants of health which individuals have most control such as personal health behaviours. On the other hand, external aspects refer to health determinants in which individuals have very little control such as social, economic, and environmental conditions (Kirch 2008). The concept of sexual health promotion activities depends on the following factors: (1) the overall aims; (2) the context in which activities take place; and (3) the strategies utilized in conducting the activities. An example would be sexual health promotion in relation to HIV prevention. In order to be effective, the non-compliance of people who are capable of protecting themselves from HIV by using condoms should be explored to gain a deeper understanding of such behaviour (Gorin & Arnold 2006). There is a misconception or myth surrounding sexual health and disability which illustrate people with chronic illness or disability as individuals lacking sexual urges or experience. This is attributed to the fact that society perceives persons with disabilities as helpless, considering the idea of possessing sexuality as far-fetched (Kaufman 2007). 2.0 The link between health promotion and disability Smeltzer, Bare, Hinkle and Cheever (2010) pointed out sexuality as a very crucial, albeit largely denied aspect of sexual health among persons with disabilities. Sexuality is not just confined to biological functioning but rather as an individual’s perception of masculinity and femininity. In addition, the concept of sexuality covers how an individual reacts to other people, as well as how other people perceive the individual. This also includes physical intimacy, emotional intimacy, and caring. The main cause of sexuality problems among people with disability is rooted on the following: (1) limited amount of information available regarding sexuality among persons with disabilities; (2) difficulty in creating and maintaining friendships and loving relationships; (3) poor self-image; (4) degraded self-esteem. Moreover, people with disabilities may have physical and emotional impediments that tend to complicate and disrupt attempts to lead a normal sexual life. For example, persons suffering from diabetes or those who sustained spinal cord injuries may find it difficult to initiate or maintain an erection. Patients suffering from heart ailment and stroke victims would hesitate to engage in sexual activity out of fear of triggering a life-threatening event such as a heart attack or another stroke. Individuals with bladder or bowel control issues may avoid engaging in intimate moments because of obvious reasons (Smeltzer, Bare, Hinkle & Cheever 2010). The relationship between the patient and his or her partner may become strained. If the partner is involved in providing care to the patient most of the time, it is more likely that the drive to engage in sexual activities will diminish in time. There is a misconception that the loss of an individual’s sexual function equates to loss of sexual urge or feeling. The truth is, despite losing the physical ability to initiate intimate activities, sexuality remains as an important part of the lives of persons with disabilities (Smeltzer, Bare, Hinkle & Cheever 2010). The physical loss of function might be devastating news for some individuals with disabilities. However, the burden becomes heavier when compounded by the apparent lack of knowledge of health care providers in the subject of sexuality among persons with disability. This is in addition to misconceptions about persons with disabilities lacking sexuality and perceiving them as asexual, effectively ignoring a patient’s need for healthy intimacy (Smeltzer, Bare, Hinkle & Cheever 2010). 3.0 Meeting disability sexual needs through health promotion interventions Gorin and Arnold (2006) emphasized the need for sexual health interventions among persons with disabilities due to the fact that the most serious sexual health issues involve the following: (1) Sexually Transmitted Diseases of STDs; and (2) Acquired Immune Deficiency Syndrome or AIDS. The most serious STDs include Chlamydia, gonorrhoea, and human papillomavirus (HPV). Chlamydia has become the most prevalent infectious disease in the United States alone. The Centres for Disease Control and Prevention (CDC) reported more than 850,000 cases in 2003. Gonorrhoea comes in second place with 335,000 cases. These figures only represent reported cases. The CDC estimated that the estimated figures, including unreported incidents, may reach as high as 2.8 million cases for Chlamydia and 718,000 for gonorrhoea. On the other hand, human papillomavirus infections are the most prevalent type of infections in the United States. There is an estimated 20 million cases of sexually-transmitted HPV infections. In addition to this, more than one out of five Americans are infected with viral sexually-transmitted infections other than HIV (Gorin & Arnold 2006). Regarding HIV/AIDS, despite efforts to slow down the spread of the disease for the past twenty years, it has spread worldwide and has become a major threat to public health. An estimated 40,000 positive HIV/ADIS cases are added each year in the United States. During the period of 1994 to 2000 it was observed that the number of cases started to level off. However, it was also noted that infections among homosexuals are beginning to increase in the past years (Gorin & Arnold 2006). Aside from the spread of STDs and HIV/AIDS, another reason that emphasized the need for sexual health promotion is the growing number of teenage pregnancies. The number of reported pregnancies in 2000 reached 83.6 pregnancies per 1,000 women aged fifteen to nineteen. A disturbing fact associated with this figure is that 1 out of three of these pregnancies ended up in abortion (Gorin & Arnold 2006). Lastly, the prevalence of sexual dysfunctions among individuals with poor physical and emotional health is mostly attributed to negative sexual experiences which usually involve violence, coercion, and intimidation. It is estimated that around 9 percent of the high school student population have experienced forced sexual intercourse. Moreover, one out of six women and one out of thirty-three men have experienced successful and unsuccessful sexual advances at least once (Gorin & Arnold 2006). References Gorin, SS & Arnold, JH 2006, Health promotion in practice, John Wiley & Sons, San Francisco, CA. Healey, BJ & Zimmerman, RS 2010, The new world of health promotion: New program development, implementation, and evaluation, Jones & Bartlett, London. Kaufman, M 2007, The ultimate guide to sex and disability: For all of us who live with disabilities, chronic pain, and illness, Cleis Press, San Francisco, CA. Kirch, W 2008, Encyclopaedia of public health, Springer, New York. Smeltzer, SC, Bare, BG, Hinkle, JL & Cheever, KH 2010, Brunner and Suddarth’s textbook of medical-surgical nursing, Lippincott, Williams & Wilkins, Baltimore, MD. The Independent 2008, Nurse bought disabled teenager sex aid, viewed 27 April 2011, http://www.independent.co.uk/news/uk/home-news/nurse-bought-disabled-teenager-sex-aid-947887.html Read More