5 HW003 - UNDERSTANDING PUBLIC HEALTH APPROACHES.

UNDERSTANDING PUBLIC HEALTH APPROACHES
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Understanding Public Health Approaches
Data collected since the 1980s about HIV in the UK reveal that men who have sex with men (MSM) remain the most vulnerable group. One significant reason for this trend is this population have poor sexual health practices. This exposes them to a higher risk of HIV infections. The situation is even more challenging since the gay community still face stigma in society. So, public health approaches must have more robust initiatives in place to ensure the equal treatment of this demographic The Public health England has promoted measures meant to improve the sexual health of men who have sex with men (MSM). Due to the high rate of HIV infections amongst MSM, many public health campaigns have been launched across the UK, targeting them. Also, laws such as the Equality Act of 2010 protect the rights of people with HIV. It ensures that gay men are safeguarded from discriminatory practices in the healthcare system (Nash et al. 2018). This paper first looks at the extent of HIV in the gay community in the UK. Second, it describes the impact of social factors on this public health issue. Then, it explains the public health approaches taken by the UK. Lastly, the paper identifies an effective policy that addresses the HIV issue within the gay community.
Part 1
Analysis of statistics
In the UK, over 100,000 people are infected by the HIV pandemic and around 7,000 undiagnosed. Statistics show that more than half of new HIV diagnosis comes from bisexual or gay men. This shows the high prevalence rate of HIV amongst the gay population. Gay people have been the most affected by this pandemic. A significant challenge in the fight against HIV in the UK is late diagnosis. Data from 2017 shows that over 40% of HIV cases in the UK are late diagnosis. These late diagnosis cause many deaths since patients find out about their status when the disease has advanced while earlier diagnosis could have prevented these deaths. Amongst the gay population, those undiagnosed with HIV are about 4,200 men. Late diagnosis becomes dangerous since gay people with multiple sexual partners may unknowingly spread the virus to others. In recent years, the UK has witnessed a lower rate of HIV diagnosis. Since 2016, there has been a reduction in the number of new diagnoses. The year 2017 recorded a 20% drop from 2016 in the number of a new diagnosis. Some of the public health approaches that have led to this downward trend include increased awareness, stronger legislation, and robust HIV control initiatives (Avert 2019). Also, viral suppression has increased in the UK due to broader access to antiretroviral treatments.
Statistics from the UK's public health indicate that close to 50,000 gay men have HIV. To put it into perspective, out of a sample of 1000 MSM, over 80 are HIV positive. The highest prevalence rate per 1000 MSM is in London, with over 130 men living with HIV. Due to the rise in HIV infections among the gay population, the UK has increased its testing capacity for gays.
Health surveys showed that about 75% of men who are diagnosed with HIV don't have regular tests. As a result, The UK government has been at the forefront of encouraging MSM to test for HIV regularly. They advise them to test at least once annually. If they have casual sex or have a new partner, they are encouraged to test after three months. In 2017, more than 100,000 gay men were tested for HIV (Nash et al. 2018, p.11). This testing campaign has helped create greater sexual health awareness for MSM and reduce infections.
London remains the hotspot for new HIV diagnoses among gay men. London has one of the largest gay communities in Europe. Household surveys in London show that less than 2% of the adult men's population identify as gay or bisexual. However, they form more than 50% of the new diagnosis. The majority of these new diagnoses are from the 25-49 age group. Notably, men in their forties have the highest prevalence rate of HIV amongst MSM in London. Such interventions as increased access to testing and earlier prevention treatments saw the numbers drop by 31% between the years 2015 to 2017 (Nam 2014). So, interventions by Public health England has helped reduce the number of new infections in London.
The HIV prevalence rate amongst the gay population has gradually dropped in the UK over the last decade. The robust measures taken by clinics, hospitals, and public health institutes have helped create effective preventative measures to reduce the spread of this pandemic. The situation has improved evidently by statistics from National Health studies conducted since the 2010s. The data reveal a downward trend in HIV infection and diagnosis. Hotspot areas like London continue to show progress in reducing the number of new diagnoses. The public health institutes have played a significant role in this positive trend. They have encouraged measures such as early diagnosis and regular testing within the gay population, which have helped mitigate the spread of the disease.
Part 2
Dahlgren-Whitehead 'rainbow model'
Various factors influence the health of the gay population across all age groups. Several models are used to analyze factors causing health inequity in the UK. One popular model is the Dahlgren-Whitehead 'rainbow model' which was developed in 1991 by researchers Göran Dahlgren and Margaret Whitehead. The model assesses the determinants which affect health. It seeks to establish how individual and environmental factors influence health. These interrelationships help experts understand their impact on health inequalities and outcomes. The model has three layers. Its first layer is individual factors such as genetics, age, sex, and lifestyle. Then, the other layers focus on socio-economic, environmental, and cultural issues such as lifestyle, community, social, living, and working conditions that affect health. One has control over individual factors. However, an individual has little control over some social or community factors. Social factors play an integral role in determining whether a person can access effective treatment and preventative services (Rice and Sara 2019). The Dahlgren-Whitehead 'rainbow model' has been useful in designing policies that promote health equity.
Impact of Social determinants
Education
Sex education impacts the health outcomes within the gay population. Lower levels of education have been associated with adverse health outcomes. Gay men who have lower sex education have higher incidences of HIV diagnosis. They are likely to engage in unhealthy sexual practices. Their limited HIV awareness exposes others to the disease as they don’t take any precautionary measures to protect themselves. However, gay men with higher sexual education are likely to engage in more healthy and safe sexual practices. They tend to avoid risky behaviors that expose them to the virus. They are also likely to go for regular tests since they understand the significance of early diagnosis. So, promoting sex education will help in addressing HIV disparities within the MSM population. (McDermott, Hughes and Rawlings 2018). For example, the UK government has been promoting greater sexual education among the gay community. This move is meant to create awareness of some of the protective or preventive measures they can take to avoid contracting HIV.
Unemployment
The gay community faces higher unemployment rates than other groups due to the stigma associated with their sexual orientation. Many employers in the UK are still less tolerant of gays. This situation leads to many gay men being unemployed. The UK continues to experience an increase in gay male sex workers. Many of these have resorted to this type of work to earn income. Their poor working conditions increase their susceptibility to contracting HIV.
Further, unemployment leads to adverse health outcomes. Gay sex workers have lower access to effective preventive or treatment services. This exposes many of them to early death as a result of late diagnosis of HIV (McDermott, Hughes and Rawlings 2018). For example, unemployment may drive gay men into sex work for survival. They may have un...