Social Determinants of Health on Men Who Have Sex with Men - Term Paper Example

Essay Name: University: Date: Impact of Social Determinants of Health on Men Who Have Sex with Men in United States and Australia Introduction In the United States, over 1.2 million people are HIV-positive with almost 12.8 (156,300) per cent being unaware that they are infected. Men who have sex with men (MSM) such as bisexual and Gay, especially young African/black Americas account for a high percentage of people living with HIV in US (CDC, 2015). In Australia, more than 27,150 people are living with HIV, of whom 12 per cent are not aware they are positive (AFAO, 2012). In 2011, almost 57 per cent of HIV-positive persons in the U.S. were MSM and this is the similar case in Australia where 75 per cent of people living with HIV got it from men who have sex with other men. In both United States and Australia, MSM is the only risk group accounting for a high percentage of new HIV infections. In Australia, MSM accounts for 66 per cent of persons who were diagnosed recently with 25 per cent being infected through heterosexual contact. In Australia, new HIV diagnoses have since 2012 remained stable with only more than 1,000 new HIV cases being reported between 2012 and 2014. Still, many of the new HIV diagnoses (75 per cent) are taking place among MSM. In the US, MSM represents almost 2 per cent of the total population, but still they are the population affected by HIV severely.  Stigma as defined by Ayala, Beck, Lauer, Reynolds, and Sundararaj (2010) is a dynamic devaluation process, which considerably discredits a person in the eyes of others. Discrimination connotes unequal or unfair treatment (which includes acts of physical or verbal violence) intended to subordinate or marginalize communities or people in terms of their perceived or real affiliation with stigmatized traits that are socially constructed. Social justice can be defined as a view that all and sundry have a right to equal social, political and economic opportunities. The essay compares and contrasts impact of social determinants of health on men who have sex with men in the United States and Australia. Body In the United States, a number of adolescent boys have committed suicide following constant bullying as well as taunts due to their sexuality. Similar stories of bullying and persecution due to sexual orientation are prevalent in Australia. Living with HIV can result in significant discrimination as well as stigma against the affected persons. According to Altman et al. (2010), perceived sexual orientation is among the factors that contribute to social discrimination facing MSM. Besides that, MSM can be stigmatized because of other identities such as drug users, sex workers, migrants or persons living with HIV. In the US, stigmas intensify the challenges of unveiling health status to health service providers or sexual partners; thus, deteriorating a person ability to take part in health promoting behaviours as well as in negotiating sex practices that are safer. MSM stigmas in US are attributed mainly to lack of knowledge, which result to confusions with regard to risk of HIV transmission as well as the fear of being infected. Furthermore, negative representations of MSM living with HIV bring about stigmatizing attitudes. Stigmas against HIV-positive MSM can impede their involvement in HIV prevention efforts; thus, reducing early intervention opportunities as well as possibly reducing the overall life quality. Even though same-sex relationships acceptance in US has increasing steadily, stigma and homophobia still persist. In Australia, there is persistence of HIV-related stigma , especially for the MSM; thus, stopping MSM living with HIV from revealing their HIV status to family and friends, work colleagues as well as employers, insurance companies and health care providers, and even their sexual partners. According to Liamputtong (2013), discrimination and stigma that MSM experience, especially those living with is also undermining prevention programs as well as access to treatment and testing. In Both US and Australia, HIV-positive MSM experience greater discrimination as well as social isolation as the result of being HIV-positive including loss of employment or housing because of their HIV status. Basically, MSM experiencing harassment and discrimination are inclined to involve in risk behaviour. Threats as well as violence from sources such as family members are related to increased risk behaviours like unprotected anal sex. In US, Latino MSM experience hostile behaviours such as persecution from their families; therefore, majority conceal their sexual orientation by pretending to be heterosexual, which is also associated with high-risk sexual behaviour. In both Australia and US, MSM accounts for a high percentage for people living with HIV as compared to other risk groups. Most MSM extremely lack access to care and treatment from the private NGOs and governments as well as social or religious welfare groups who fail to recognise their way of life, rights and needs. United States government have tried to improve its relationship with MSM, but this relationship is non-existent in most Australian states. The non-existence of this relationship in most Australian states is encumbered as well as determined by the failure to recognise MSM as well as failure, resistance, or even denial of private or public entities to recognise the MSM existence. This form of social injustice develops from competing or prevailing religious, social and political attitudes towards MSM and homosexuality, informed through stigma and prejudice related to HIV as well as homosexual activities. Jones (2013) posits that the existing approaches to curbing discrimination as well as promoting social justice are poor in their coverage and have resulted on the denial of benefits and rights MSM, while bestowing as well as elevating benefits and rights upon other members of the society in a way that is harmful to MSM. A number of intimacies have been recognised in Australia but some states do not recognise. Outlawing MSM in a number of Australian states have resulted in structural limitations, which reinforce stigma and promote discrimination, tolerate violence; thus, negatively affecting the ability of social workers to offer services to MSM adults and youths openly. Many MSM in Australia are experiencing marginalisation mainly because the territory, state and federal laws have failed to offer MSM and uniform protection from discrimination. This is evident in Queensland as well as Tasmania, which do not legislative protection. However, Victoria has lately introduced different new protective laws. Even though divided sharply, the attitudes of public toward MSM in US has changed rapidly and has been accepted by most people within the society, especially by the younger generation. Currently, according to Pew Research Center (2013), almost 90% of Americans know a person who is either gay or lesbian, and nearly 25 per cent know them in person. For MSM, their major social acceptance has been brought about by Americans recognizing a MSM. One way of overcoming the growing prevalence of HIV-positive MSM is through education. Ironically, HIV education in Australia is challenged by high HIV health literacy levels as well as the arrival of casual sex risk reduction as key inclination in the lived sex cultures. A sexually sophisticated as well as highly informed target group mostly effectively and rapidly acclimates to new information by shifting between various forms of strategies for HIV prevention. The MSM acceptance is principally challenging amongst conservative religious communities as well as ethnic minorities in Australia, and this is despite the effort by federal government to change the silence culture that surrounds MSM in attempt to facilitate social acceptance. In US, friends and family have played a crucial part in MSM acceptance, but government have failed to involve family members of so as to boost social acceptance of MSM so as to reduce discrimination and enable MSM to take part in HIV prevention interventions. In Australia, people have been reluctant to supports government initiatives that seek to enhance the MSM social acceptance, but still violence against MSM is still prevalent. The most notable measure to reduce HIV prevalence amongst MSM has been through legalising same-marriage. Conclusion In conclusion, the essay has compared and contrasted impact of social determinants of health on MSM in the United States and Australia. As indicated in the essay, the nexus between HIV as well as human rights is challenging to both address and define with MSM populations. The challenge is attributed to vital lack of a recognizable population from different cultures as well as different barriers to HIV education, testing as well as treatment of MSM since they are more at risk of getting HIV as compared to the general population. As pointed out in the essay, MSM are less inclined to participate in HIV prevention initiative because of the stigma as well as the religious, social and formal political condemnation of MSM and other homosexual behaviours. In both US and Australia, MSM find it challenging to access education, testing as well as treatment as compared to other HIV risk group. This is in spite of the fact that MSM accounts for more than half of the total people living with HIV. Contrary to other recognized goals of HIV prevention and education, government efforts to reach MSM equally have failed both in US and Australia. For this reason, the risk of infection amongst MSM has lately increased tremendously. References AFAO. (2012, October 15). HIV statistics in Australia. Retrieved from Australian Federation of AIDS Organisations: https://www.afao.org.au/about-hiv/the-hiv-epidemic/hiv-statistics-australia Altman, D., Aggleton, P., Williams, M., Kong, T., Reddy, V., Harrad, D., . . . Parker, R. (2010). Men who have sex with men: stigma and discrimination. The Lancet, 380, 439-445. Ayala, G., Beck, J., Lauer, K., Reynolds, R., & Sundararaj, M. (2010). Social Discrimination Against Men Who Have Sex With Men (MSM) Implications for HIV Policy and Programs. Oakland, CA: The Global Forum on MSM and HIV (MSMGF). CDC. (2015, July 1). HIV in the United States: At A Glance. Retrieved from Centers for Disease Control and Prevention : http://www.cdc.gov/hiv/statistics/basics/ataglance.html Jones, S. V. (2013). Men and Boys and the Ethical Demand for Social Justice. Washington and Lee Journal of Civil Rights and Social Justice, 20(2), 507-544. Liamputtong, P. (2013). Stigma, Discrimination and Living with HIV/AIDS: A Cross-Cultural Perspective. New York: Springer Science & Business Media. Pew Research Center. (2013, June 13). Chapter 2: Social Acceptance. Retrieved from Pew Research Center: http://www.pewsocialtrends.org/2013/06/13/chapter-2-social-acceptance/ Read More