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Social Determinants Of Health: Sex Workers- Australia Vs. Thailand

Question

Task: This assessment requires you to examine, compare and contrast social determinants of health in the context of HIV/AIDS. This will involve selecting two social determinants of health and one vulnerable group.

Answer

Introduction
This individual report focuses on advances and success in implementing a system for social determinants such as Health Care and Education in order to counter interrelated epidemics of Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS)(Jung et al., 2019).

Here in this report, the vulnerable group chooses are the sex workers and will be compared with Australia and Thailand’s statistics. The social determinants choose in the case are Education and Health care system. The reason behind choosing this determinant is clearly because proper education and health care facilities can help the factor of HIV/AIDS to diminish. Sex education plays an important role for people who appear to face a relatively high burden of HIV internationally is a crucial factor in the prevention of HIV(Callanderetal., 2018). In order to examine the feasibility of these initiatives for changing awareness and risk behaviour in HIV-related countries, the study thoroughly evaluated and meta-analysed the current evidence of sex education centred approaches in Australia and Thailand.Whereas, health care systems also plays a significant role in impacting sex workers by conducting several portfolios andpreventive measure guidance. Hence, Education and Health care are the two most suitable social determinants for the vulnerable group Sex workers.

HIV/AIDS and the vulnerable group – the Sex workers Australia vs Thailand
Sex workers-Australia

In Thailand, almost 70 million inhabitants, about 470,000 had HIV and 14,000 died of AIDS-based conditions in 2019. The region is the region with the highest number of HIV-populating communities in East as well as South Africa, Asia and the Pacific, with a significant proportion in Thailand.Although official testing statistics for UNAIDS targets 90-90-90 remain insufficient, care and viral suppression target data, existing figures indicate that approximately 80 per cent of all HIV-positive people in Thailand were being treated as of 2019(Canidate& Hart, 2017). > 95 per cent are virally suppressed by those undergoing medication (Dalton & Jung, 2019). Sex workers account for about 40% of new infections annually. Migrants and inmates in the world are even more prone to HIV than others. In 2019, 5,400 Thais were HIV-positive. An estimated 90% of all current HIV infections are unprotected sex(Jung et al., 2019).

Sex workers-Australia
In 2017, 27,545 people with HIV in Australia were estimated. Among 27 545 individuals, estimated 89 per centwere diagnosed by the end of 2017 (Muangma&Lalitanantpong, 2018). The study also indicates that 95% access to care, 87% received HIV medication, and 95% received undetectable viral load from those received treatment.Sexual encounters with sex workers accounted for 63 per cent of HIV alerts in 2017. 25 per cent were assigned to heterosexual sex, 3 per cent to injecting medication only and 3 per cent to other or non-specified variations of physical intercourse involving men and substance use(Canidate& Hart, 2017).The percentage of males who were regularly tested within seven months of their last examinations between 2013 and 2017 increased 36% for sex workers in sexual health clinics.

Social determinant – Education
In particular, the emphasis on these conditions is timely considering the evidence of rising burdens and deteriorating health inequalities, the development of our perception of socioeconomic and structural effects on epidemiological diseases and the large repercussions of the global economic downturn.The human immunodeficiency virus is responsible for HIV infection. Contact with contaminated blood, sperm, or vaginal fluids can lead to HIV. Many people catch the virus from someone who has HIV after having casual sex. Therefore, proper education on the Sex for young generation as well as for the sex workers is very important. Here is the social determinant factors of both the countries.

In context to Thailand
Almost all general secondary and technical institutions offer an incorporated or standalone sex education (CSE), or both. It is not available for younger students but available for the sex workers.Different subjects include teenagers’ prevention, sexually transmitted HIV, HIV infections, and sexual anatomy and growth, among other items. CSE curriculum. However, issues relating to ethnicity, reproductive rights, sexual orientation, gender discrimination, secure abortion and safe sex are less commonly taught in same-sex couples.Studies have found that in Thailand’s, people under the age of 25 years are lower than in Thailand, with a lower rate of HIV knowledge and HIV diagnosis and counselling than those over 25,65 In 2016, there is only about 45 per cent of sex workers with sufficient knowledge of how to avoid HIV.66(Zappullaetal., 2020).

In context to Australia
Sexual wellbeing means physical, emotional and social welfare as far as sexuality is concerned. The attitude to sexuality and women, as well as the prospect of having pleasurable and healthy sexual encounters without harassment, sexism and abuse, is constructive and compassionate. The World Health Organization (WHO) argues that young people should access, in order to cater to their sexual health, to relevant qualifications based education(Jung et al., 2019).Sex education in Australia provides some of the basic studies in the following topics, for the prevention of HIV/AIDS: Take rational decisions about sex and ties and justify these decisions, Fix unwanted sex or substance use pressures, Recognize a condition that may become unsafe or aggressive, Know-how and when to request help and assistance, Know how to discuss safe sex and other aspects of safe sex while ready for sex.

Social determinant-Health Care System
In context to Australia

Since the early 1990s, antiretroviral (ART) treatment of HIV infection has been considered a possible form of HIV prevention. Researchers projected that universal sexually active adult HIV monitoring and the prompt initiation of all HIV-infected persons into ART could dramatically reduce the incidence of HIV, putting treatment-as-prevention squarely on the agenda of HIV prevention.In addition to increasing concerns about the continuing and growing of health inequities, the final report of the Committee on Social Determinants of Health 2008 of the World Health Organization27 included many broad-based recommendations on overcoming social and systemic health barriers: reform of daily conditions of life; combating the unequal allocation of electricity, funds and resources; All of these methods are applicable and ideal for developing services in the U.K and abroad for HIV, viral hepatitis, TBI and TB prevention(Canidate& Hart, 2017).What is actually required is a fundamental change in the ability to follow this more inclusive strategy to preventive partners at global, state and local levels. For those planning and providing preventive programmes, it is increasingly inappropriate that SDH should be dealt with outside of their competence to abstain from further intervention. In comparison, prevention practitioners must begin to define the alliances, partnerships, studies and policy initiatives that will promote creative and sustainable action overtime to deal with these social and systemic determinants.A diverse portfolio of preventive interventions, including person, network interventions, has also been adopted by many jurisdictions such as strengthening community coordination and alignment of services; engaging in economic experiences to consider possibilities for more aggressive policy and legislative approaches to improve preventive environments.

In context to Thailand
The goal of the TAACP was to develop a fully integrated AP model for people with HIV / AIDS at the Hospitals. It also sought to help families and patients by improving the recruitment of health care staff, operational support and the advancement of facilities. The TAACP was sponsored by the AusAID and was audited and assessed successfully(Callanderetal., 2018). The care model employed in Hospital has been adapted to focus on economic options, including the improvement of health workers’ know-how and skills in providing a range of core HIV/AIDS care services.While most of the patients could not afford antiretroviral therapies at that stage, many were unable to afford opportunistic infections for medication.

Recommendation
A variety of interventions is important to minimise HIV transmittance among people who use drugs such as: Avoid bigotry and marginalisation-people who inject drugs are faced with severe discrimination from a wide number of social sectors, including poor representation in medical trials(Sodik, 2018). Initiatives of HIV prevention must focus on subgroups such as opioid consumers or young people who use drugs(Khezriet al., 2019). In addition to the harm prevention steps, access to mental health services, reproductive health checks and condoms is required. Efforts must concentrate instead of only information on prevention. Proper guidance of sex education to sex workers is a very crucial aspect in thisera; sex education must be implemented in the syllabus for young students also. Health care must focus more on this issue and conduct several campaigns and programs for sex workers to prevent HIV AIDS.

Conclusion
From the above report, it can be concluded that the number of sex workers in both countries are gradually increasing in every decade. The infection from the Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) has decreased apparently. Comparatively, the sex education system has improved a lot in both the countries, Australia and Thailand, but there still needs to be some proper implication of the study for better preventions and measures. Sex workers of both countries have a high risk of Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome. The global response to HIV is significant, including people who use drugs in research Avoid apathy many of culture is oblivious to the interests of people who use drugs; the same civil rights as other people must be shown. Avoid carelessness-those injecting medications are too often viewed as homogenised.Therefore, the health care facilities of such countries are needed to have proper look upon conducting several campaigns and programs to educate and test the health status of the sex workers of both countries.

Reference
Callander, D., McManus, H., Guy, R., Hellard, M., O’Connor, C. C., Fairley, C. K., & Schmidt, H. M. A. 2018. Rising chlamydia and gonorrhoea incidence and associated risk factors among female sex workers in Australia: a retrospective cohort study. Sexually transmitted diseases, 45(3), 199-206.

Canidate, S., & Hart, M. 2017. The use of avatar counseling for HIV/AIDS health education: the examination of self-identity in avatar preferences. Journal of Medical Internet Research, 19(12), e365.

Dalton, B., & Jung, K. 2019. Becoming cosmopolitan women while negotiating structurally limited choices: The case of Korean migrant sex workers in Australia. Organization, 26(3), 355-370.

Jung, I. Y., Rupasinghe, D., Woolley, I., O’Connor, C. C., Giles, M., Azwa, R. I., &IeDEA Asia?Pacific. 2019. Trends in mortality among ART?treated HIV?infected adults in the Asia?Pacific region between 1999 and 2017: results from the TREAT Asia HIV Observational Database (TAHOD) and Australian HIV Observational Database (AHOD) of IeDEA Asia?Pacific. Journal of the International AIDS Society, 22(1), e25219.

Khezri, M., Farokhzadian, J., Nematollahi, M., Foroughameri, G., &Sharifi, H. 2019. HIV/AIDS prevention education: An effective tool for enhancing street children’s knowledge and attitude. A randomized controlled trial. Children and Youth Services Review, 104, 104351.

Muangma, N., &Lalitanantpong, D. 2018. Resilience and social support in HIV/AIDS clients at the HIV Netherlands Australia Thailand Research Collaboration, Thai Red Cross AIDS Research Centre. Chulalongkorn Medical Journal, 62(6), 947-963.

Sodik, M. A. 2018, September. Analysis of Improved Attitude of Youth in HIV/AIDS Prevention through the Provision of Health Education with Peer Education.In The 2nd Joint International Conferences (Vol. 2, No. 2, pp. 495-502).

Zappulla, A., Fairley, C. K., Donovan, B., Guy, R., Bradshaw, C. S., Chen, M. Y., & Chow, E. P. 2020. Sexual practices of female sex workers in Melbourne, Australia: an anonymous cross-sectional questionnaire study in 2017–18. Sexual Health, 17(1), 53-60.

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