Gay Risks and Health Status - Essay Example

Risks and health status of vulnerable population: Lesbians, Gays, and Bisexuals (LGB) Several conceptual models for studying vulnerability have beencreated for identifying inequalities with respect to the discrimination of societal resources. Investigations reveal that vulnerable populations suffer from disproportionate rates of poor health and their life expectancy is significantly shorter, and lack or resources, rather than presence of risk factors is the best predictor of this condition. Lesbian, gay, bisexual and transgender (LGBT) youth are exposed to higher risk for mental disorders, HIV/AIDS, and suicidal ideation because of lack of social support, a sense of isolation, stigma associated with seeking help, loss of a relationship, and social discrimination. Since gay population is vulnerable to more health disparity and social discrimination it is projected that population-specific, culturally appropriate responses will be able to address their vulnerabilities. There are many conceptual models for studying risks and health status of vulnerable populations, such as vulnerable population conceptual model (VPCM), and minority stress theory. The vulnerable population conceptual model (VPCM) proposes “an interactive relationship among resources availability, relative risk, and health status of vulnerable populations” (Fitzpatrick, Nyamathi, & Koniak-Griffin, 2007, p.7). Minority stress is “defined as the chronic social stress that individuals with stigmatized identities experience as a direct result of prejudice and discrimination over and above the stress of daily living.” (Rostosky et al, 2009). More recent and a general framework to study vulnerability developed by Shi and Stevens proposes that “vulnerability is influenced by individual’s predisposing, enabling, and need attributes, and also influences risk factors at an ecological or community leve.” (Fitzpatrick, Nyamathi, & Koniak-Griffin, 2007, p.11) They also suggested that “a gradient relationship exists between vulnerability status and health care access, quality, and health outcome” Vulnerable population is defined as “social groups who have increased morbidity and mortality risks,” who are at the risk of “poor psychological, physical, or social health,” and traditionally comprise “women and children, ethnic people of color, gay men and lesbians, immigrants, homeless people,” etc. (Fitzpatrick, Nyamathi, & Koniak-Griffin, 2007, p.4). Major reasons offered by Shi and Stevens (2005) for focusing national attention on vulnerable population is that: these groups have “greater health care needs,” their prevalence continues to escalate; vulnerability is a societal issue, vulnerability and the nation’s health and resources are interrelated; and there is growing emphasis on equality with respect to health. (Fitzpatrick, Nyamathi, & Koniak-Griffin, 2007). Investigation by Simon et al (2006) to identify differences on the basis of sexual orientation in victimization, substance use, and HIV risk behaviors in American Indian “two-spirit” men, found that “they suffer from disproportionate rates of poor health” and has “the life expectancy, significantly shorter” as compared to men in general population. Early death is caused in “part by disproportionate rates of homicide, suicide, and motor vehicle accident,” which is related to “voluntary risky behaviors” such as alcohol and substance abuse (Simoni, et al, 2006).Literature reviews indicate that “fear of discrimination and stigma cause many GLBT individuals to postpone or decline, seeking medical care” and even those taking care sometimes withhold personal information from their providers. (Community standard of practice for the provision of quality health care services to lesbian, gay, bisexual, and transgender clients, (n.d)). Research evidence suggests that lesbian, gay, bisexual and transgender (LGBT) youth have “higher suicide attempts and suicidal ideation than their heterosexual peers” and “suicide and suicide ideation are associated with depression and substance abuse.” (Suicide risk and prevention for lesbian, gay, bisexual, and transgender youth, 2008). The risk factors for higher suicide attempts among LGBT population include mental disorders, lack of social support, a sense of isolation, stigma associated with seeking help, loss of a relationship, and many other factors. Studies also reveal that in the United States “prejudice and discrimination against LGB people are widespread among individuals” that are supported by many religious, social and government institutions (Suicide risk and prevention for lesbian, gay, bisexual, and transgender youth, 2008). Research evidence suggests that “compared to their heterosexual counterparts, gay men and lesbians suffer from more mental health problems including substance use disorders, affective disorders, and suicide.” (Meyer, 2003). Statistics show that an “estimated 2.5 million people became newly infected with HIV, worldwide in 2007”and high risk populations include some of the most vulnerable groups in society (Population at risk, 2007). “It is estimated that sex between men accounts for between 5 and 10% of HIV infections worldwide” and the transmission through this route may exacerbate the situation. (HIV AIDS and men who have sex with men, 2009). Since AIDS was first discovered among self-identified young gay men in the U.S, and high prevalence of HIV is reported among men who have sex with men (MSM) the health challenges of the gay vulnerable population is not an isolated problem. Alcohol and drug abuse, and anal sex and having self-righteous or negative attitude towards safer sex among gays act as contributing factors to HIV/ AIDS infection. Discriminatory attitude of government agencies against gays and public perceptions against such relationships promotes social isolation and discreet encounters leading to more unnoticed health related problems among this marginalized and vulnerable population. It is suggested that “empowering MSM and other marginalized groups to protect themselves from HIV is one of the world’s most urgent health priorities.” (HIV prevention that works, 2009). Research evidence suggests that gay men and lesbians suffer from more mental health problems, compared with their heterosexual counterparts, and the “cause of the higher prevalence of disorders among LGB people is that stigma, prejudice, and discrimination create a stressful social environment” for people who belong to stigmatized minority groups. (Meyer 2003). The gay population in the U.S. is vulnerable to victimization and is exposed to health care disparity. The “internationalized homophobia” or victimization of LGB may lead to stress and contribute to suicide risk, which may be compounded by a “lack of protective factors that normally provide resilience, such as family connections, peer support, and access to effective health and mental health providers.” (Suicide risk and prevention for lesbian, gay, bisexual, and transgender youth, 2008). Reports further suggest that treatment of LGBT people by health care providers are hostile and substandard and “some mental health care providers still consider an LGB orientation pathological.” In this context it is hypothesized that the guidelines for psychotherapy with lesbian, gay, and bisexual clients (LGB) adopted by APA (Division 44/Task Force 2000) may “serve to sensitize practitioners to the issues that can arise during therapy” with LGB population (Cochran, D, 2001, p.10). Since gay population is vulnerable to more health disparity and social discrimination it is projected that “population-specific approaches result in evidence-based, culturally appropriate responses that are better able to address the realities and vulnerabilities, that contribute to infection and poor health outcomes for the target groups. ” (Population at risk, 2007). An integrated conceptual model that stress more on identifying and eliminating social stigmatization of lesbian, gay, and bisexual people and a population-specific, culturally appropriate responses will be able to address their vulnerabilities Reference Cochran, Susan, D. (2001).Emerging issue in research on lesbian’s and gey men’s mental health: Does sexual orientation really matter: Where does the field go from here. American Psychologist. 10. Retrieved April 7, 2009, from http://www.stat.ucla.edu/~cochran/PDF/EmergingIssuesLGMentalOrientationMatter.pdf Community standard of practice for the provision of quality health care services to lesbian, gay, bisexual, and transgender clients: Introduction. (n.d). GLBT: Lesbian, Gay, Bisexual, and Transgender Health Access Project. Retrieved April 7, 2009, from http://www.glbthealth.org/CommunityStandardsofPractice.htm Fitzpatrick, Joyce, J., Nyamathi, Adeline., & Koniak-Griffin, Deborah. (2007). Annual review of nursing research volume 25: Vulnerable population: Definition of Vulnerability and health Disparities. Springer Publishing Company. 4. Retrieved April 7, 2009, from http://books.google.co.in/books?id=iGKmnvzReF0C&pg=PA4&dq=women+and+children,+ethnic+people+of+color,+gay+men+and+lesbians,+immigrants,+homeless+people Fitzpatrick, Joyce, J., Nyamathi, Adeline., & Koniak-Griffin, Deborah. (2007). Annual review of nursing research volume 25: Vulnerable population. Springer Publishing Company. 11. Retrieved April 7, 2009, from http://books.google.co.in/books?id=iGKmnvzReF0C&pg=PA11&lpg=PA11&dq=vulnerability+is+influenced+by+individual%E2%80%99s+predisposing,+enabling,+and+need+attributes,+and+also+influences+risk+factors+at+an+ecological+or+community+level&source=bl&ots=uQTpIg1pE2&sig=8bAcdr2shk298zQYcQXMwhijWPI&hl=en&ei=XdTaSaeqK4yA7QO_0-SYCA&sa=X&oi=book_result&ct=result&resnum=1 Fitzpatrick, Joyce, J., Nyamathi, Adeline., & Koniak-Griffin, Deborah. (2007). Annual review of nursing research volume 25: Vulnerable population: Definition of Vulnerability and health Disparities. Springer Publishing Company. 6. Retrieved April 7, 2009, from http://books.google.co.in/books?id=iGKmnvzReF0C&pg=PA4&dq=women+and+children,+ethnic+people+of+color,+gay+men+and+lesbians,+immigrants,+homeless+people#PPA6,M1 HIV AIDS and men who have sex with men: HIV prevention that works. (2009). AVERT: Averting HIV and AIDS. Retrieved April 7, 2009, from http://www.avert.org/msm.htmHIV AIDS and men who have sex with men: MSM and HIV-the global picture. (2009). AVERT: Averting HIV and AIDS. Retrieved April 7, 2009, from http://www.avert.org/msm.htm Meyer, Ilan H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. PubMed Centre Journal List. Retrieved April 7, 2009, from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2072932 Meyer, Ilan. H. (2003). Prejudice, social stress, and mental health in lesbian, gay and bisexual population: conceptual issues and research evidence. Pub Med Central Journalist. Retrieved April 7, 2009, from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2072932 Population at risk: Key populations. (2007). Public Health Agency of Canada. Retrieved April 7, 2009, from http://www.phac-aspc.gc.ca/aids-sida/populations-eng.php Population at risk: Key populations: Why focus on key population. (2007). Public Health Agency of Canada. Retrieved April 7, 2009, from Retrieved April 7, 2009, from http://www.phac-aspc.gc.ca/aids-sida/populations-eng.php Rostosky, Sharon Scales., etal. (2009). Marriage amendment and psychological distress in lesbian, gay and bisexual (LGB) adults. Journal of counseling Psychology, 56(1), 56-66. Retrieved April 7, 2009, from http://www.apa.org/journals/releases/cou-jan09-Rostosky.pdf Suicide risk and prevention for lesbian, gay, bisexual, and transgender youth. (2008). SPRC: Suicide Prevention Resource Center. Retrieved April 7, 2009, from http://www.sprc.org/library/SPRC_LGBT_Youth.pdf Simony, Jane, M., et al. (2006). Victimization, substance use, and HIV risk behaviors among gay/bisexual/two-spirit and heterosexual American Indian men in New York City. American Journal of Public Health, 96(12).Retrieved April 7, 2009, from http://www.ajph.org/cgi/reprint/96/12/2240.pdf Read More