Improving Sexual Health Services in UK: Accessible & High Quality - Essay Sample

Introduction

The provision of accessible and high-quality sexual health services has been acknowledged as an important factor in improving sexual health services in the UK. It should be noted that the services that involve testing as well as treating of the STIs in the United Kingdom are free, which implies open access to all. Besides, medical practitioners are supposed to ensure anonymity to the users regarding a diversified range of settings (Guy, 2017). The practices entailed may include the general practice, sexual and reproductive health clinics, specialist genito-urinary medicine, and self-sampling services, among others. However, despite it being free, access to sexual health services has been faced with massive challenges in the country regarding demographic composition in the country (Fredriksen-Golden, 2016). Some of the challenges that have been witnessed revolve around the healthcare providers, discrimination for some people, and assumptions, among others. It has been established that men and teenagers are at a disproportional burden of STIs compared to other populations; hence, there is a need to ensure that they access the services (White, Selms, Cameron, & Taylor, 2018). Although the healthy sexual relationships yield various physical and emotional benefits, young adults are at an increased risk of contracting STIs which have negative sexual outcomes. Therefore, the population faces massive emotional issues when sharing their sexual information with care providers (Oram et al. 2016). Besides, men who have sex with other men (MSM) have a higher prevalence burden compared to women and bisexual men. To improve the sexual health services in the UK, there is a need to investigate the underlying issues, challenges, barriers, and ethical considerations to develop suitable approaches for the entire population especially the most vulnerable.

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Sexually transmitted infections have remained an important public health concern in the United Kingdom with the healthcare noting increased diagnoses of syphilis and gonorrhea as well as high rates of HIV. Therefore, medical practitioners have identified that case identification, as well as treatment, is an effective approach in facilitating prevention towards the onward transmission, implying that the strategies that improve access to the diagnostic testing are key priorities (Harvard Health Publishing, 2012). Some of the groups accessing services in the UK include online service users that involve STI self-sampling at home. These people harness the ubiquitous access to mobile technologies and combine with the advances in the diagnostics to facilitate home self-sampling (Bachman & Gooch, 2018). Some of the challenges that have facilitated this approach is the long waiting times in clinics, perceived stigma, inconvenient opening hours, and travel time as well as costs. Besides, the UK has also shown a critical demographic composition with the men who have sex with men (MSM). The medical field data has shown that the continued diagnoses of STIs are particularly inclined to the British population of MSM (Sio et al. 2018). Besides, the group remains at a high risk of HIV infection. Elford et al. (2010) indicated that the STI rates in the United Kingdom are elevated among the black as well as ethnic minorities. Therefore, the MSM population who are part of the ethnic minorities are even at a higher risk.

Ethnicity in the United Kingdom has been a major concern regarding the offering of effective medical services for decades. The classification of ethnicity in Britain is based on how people identify themselves and reflects the groups in which such people belong to. It may not necessarily reflect on a person's place of birth (Gayer-Anderson, Fisher, & Fearon, 2014). Considering the higher risk of Black and minority ethnic groups (BME) in contracting STIs, the population is still likely to face other challenges and barriers to accessing sexual health services. Another vulnerable population that has been identified is the teenagers, especially in the university and college students who are predisposed to many risks of engaging in sexual activities. According to Cassidy et al. (2018), various multi-level barriers, as well as enablers, have been identified as the key influences towards sexual health services use among the university students that provide insight regarding the low rates of service use. This population is significantly affected by the individual as well as the interpersonal level factors, which include ethnicity, biological sex, perceived risk and norms, and stigma, among others. Some of the perceived barriers that affect access to sexual health include service access, service entry, quality of services, and personal factors (Ellis & Lamis, 2007). Therefore, various stakeholder organizations like the National Institute for Health and Care Excellence (NICE) have proposed interventions that seek to improve access to sexual health services by the vulnerable. One of the approaches is the behavioral change wheel (BCW), which suggests a change in capability, motivation, or opportunity for the behavior to change.

The national strategy towards the Sexual Health interventions in the UK required the improvement of the sexual health services access especially for target populations such as sex workers and intravenous drug users among other vulnerable groups (Public Health England, 2018). However, the intervention has not been fully successful due to the numerous barriers in the UK. For example, it has been established that the lack of proper resources is a major concern when supporting attendance at services (Collumbien et al. 2012). According to Edelman et al. (2013), drug use, as well as its attendant lifestyle, depleted the necessary resources that women needed to facilitate their physical attendance services. This led to the lack of available monies as well as the washing facilities, which acted as both a practical and an emotional barrier (Saulo, Walakira, & Darj, 2012). This also led to personal hygiene issues, which with the increased emotional cost of accessing the services led to reduced access (Alexander et al. 2015). The high emotional cost, especially to women that undergo sexual health intervention in the UK, has been noted to be a significant barrier that arises from traumatic experiences, low self-regard, and drug-use stigma (Boog, Heanue & Kumar, 2018). Service providers have previously demonstrated a lack of self-regard as a key factor in reducing a participant's willingness to get medical services. Their people also tend to have a low perceived value of undergoing intervention, which is also a major barrier (Boog, Heanue & Kumar, 2018). This results from confusion regarding the intervention, instances of drug-related infertility, and poor understanding of STI. Therefore, the victims of sexually transmitted infections in the UK face serious challenges that act as hindrances to sexual health.

There are several reasons as to why health care practitioners must be aware and substantively informed of the lesbian, gay, bisexual, and transgender (LGBT) group. Health practitioners should be aware of the lengthy historical background of the activism against the LGBT group (Harley et al. 2016). These anti-LGBT practices have significantly affected the psychological behaviors of sexuality and gender-related patients as they seek and after disclosing their sexuality to the medical practitioners (Boehmer, & Elk, 2015). During the years before the early 1970s, homosexuality was officially diagnosed as a disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM) (Eckstrand & Ehrenfeld, 2016). The transgender group was categorized as a gender identity disorder in the DSM up until 2013. The years that followed, the transgender status was replaced by a patient-centered term gender dysphoria. Gender dysphoria is the distress experienced by individuals with the difference between their gender identity and their assigned sex at birth. Whenever it occurs, society can take it as clinical distress or impairment in occupational or social circles, among others (Hammack & Cohler, 2009). The patient-centered term gender dysphoria made transgender acceptable in society and with reduced stigma for the patients to report sexual issues affecting them without fear of isolation. In a bid to keep up with a pathological understanding of homosexuality, many LGBT patients could be taken through electro-shock treatments, castration, or reparative therapies as a way to fix the 'problem.' However, in the recent past, reparative therapy has been disowned as a practice by most medical professionals in society.

In the wake of some LGBT patients continuing the reporting of discriminatory healthcare experiences, it is evident that most transgender afflicted patients are suffering as they seek medical care (Goldman et al. 2013). Sexual health care practitioners also have to be informed of the various disparities among LGBT patients (Eckstrand & Ehrenfeld, 2016). There are various selected health disparities among LGBT populations. Patients within the LGBT group have been the immediate victims of healthcare discrimination as the chances of these communities to access medical care are very minimal. Same-sex relationship partners have been significantly less likely to access medical care insurance, as most of them are likely to report unmet health needs. Women specifically are less likely to undertake a mammogram or Papanicolaou test, which involves Pap smear screening. The decreased accessibility has partly resulted in the differences in the medical cover insurance to employer-sponsored health insurance benefits (Eckstrand & Ehrenfeld, 2016). This can, however, be improved in the wake of the expansion of the medical cover insurance platform under the free sexual services to all which will legalize same-sex marriage in the United Kingdom (Fish, & Karban, 2015). This move will significantly affect the access of the LGBT community to health care in America. Sexually transmitted infections, especially HIV, are a major concern among the LGBT patients, particularly MSM and the transgender women. MSM has been highly affected as they account for more than 75% of the LGBT patients admitted with HIV each year in the United Kingdom. This is despite the MSM patients consisting of only 2% of the whole LGBT group (Eckstrand & Ehrenfeld, 2016). The young group, especially the black race among the MSM, are significantly the most affected section of the group.

The decreased access to antiretroviral therapy among the non-whites has significantly contributed to the increased HIV incidences in the black population (Eckstrand & Ehrenfeld, 2016). Despite the sparsity of data based on HIV rates among the transgender persons, one systematic review indicates an estimated 28% prevalence among the transgender women group in the UK. Despite the increased acceptance of LGBT sexuality in the communities, there are still cases of violence and victimization related to homo and transphobia groups about health practices (Harley et al. 2016). In as much as the adult LGBT section suffers from victimization and violence, sexual minority high school students are more likely to be affected as they are threatened and bullied in school as well as injured by weapons while at school. This acts and accidents have led to most students avoiding school for their safety concerns.

It is vital for the medical practitioners to understand the individual challenges affecting the LGBT patients, especially their social, interpersonal as well as social challenges. This can help understand the impact these factors have on these LGBT patients. The youth sexual afflicted patients face unique challenges in society (Goodrich & Luke...