Introduction
Homeless population is a highly vulnerable social group due to various reasons. For instance, homeless individuals are often subjected to increased risks related to adverse health conditions. The nature of homelessness and its link to the resources available, the status of health and related risks can be of great significant to nurses. Greater understanding of these components will help nurses in the diagnosis and treatment of homeless population health problems. Homeless individuals are highly marginalized by the society. Large numbers of these individuals are found in the United States, Canada and other areas of the world (Cousineau, 2007). As a matter of fact, most women, parents with children, and men represent homeless population segments. People who are homeless suffer from numerous health threats (O’Toole et al, 2004). The health threats are such as hypertension, diabetes, chronic obstructive pulmonary disease, epilepsy and musculoskeletal disorders.
Mental illness and substance abuse are also highly prevalent among these populations. Despite these populations’ high levels of mortality and morbidity, they are also faced with numerous non-financial and financial barriers when it comes to obtaining health services. According to the national survey conducted in 1996 in the United States, 57% of homeless populations are uninsured. Moreover, there lack of insurance cover is related to lower utilization of ambulatory health care. Non-financial barriers also play a significant role in acquiring of insurance cover. For instance, the need for shelter and food may results to delays in pursuing health care. Clinics long waiting hours, lack of transportation to health visits and stigmatization by health care professionals are also barriers frequently reported by homeless people. Lack of appropriate health care for homeless individuals contributes to their health status decline and in some cases death (Hwang & Dunn, 2005). Thus, my study will focus on homeless African-American heterosexual men.
Background Information
HIV among homeless persons is a serious epidemic. The only way HIV transmission can be reduced is by undergoing testing. In addition to that, HIV testing helps in combating HIV/AIDS that impact on homeless people disproportionately. On the contrary, little is known with regards to homeless men HIV testing behavior. Despite HIV testing widespread availability, majority of HIV positive individuals in the United States are unaware of their condition (Centers for Disease Control and Prevention, 2010). Furthermore, homelessness hinders individuals from HIV diagnosis. Routinely HIV testing is an effective way to combat HIV/AIDS disparities among homeless men. This is because; they only know their status when the disease has worsened. In the year 2009 in the United States, men account for seventy five point five percent (75.5%) of new HIV infections. Among men, HIV transmission is via heterosexual activities which accounts for thirteen point eight percent (13.8%) of new infections. HIV testing is a significant risk reduction method for populations that are at high risk of conducting HIV. These populations are such as homeless men who are heterosexually active. Factors that might interfere with HIV testing are not well understood making HIV testing among homeless populations be mandatory. By virtue of them being transient and homeless, this group is the most marginalized.
Structural factors such as access to services plays a crucial role in determining when an individual is HIV tested. Previous research have documented that exhibiting a medical source of care that is regular and multiple encounters with medical service practitioners is linked to increased rate of HIV testing (Hwang et al., 2010).
Cultural, psychosocial, and Socioeconomic Concerns
African Americans have been bound by historical experiences which have resulted to their strength culturally including their survival skills. They have a history of chronic and acute oppression from which they have faced undiagnosed and unmeasured sexual and physical trauma, anxiety, depression and posttraumatic stress disorder. Heterosexual trauma is often triggered by lack of their relationship being mainstreamed in their respective cultures. As a result, they often experience some intrapsychic and psychosocial reactions. In times of bereavement, heterosexual men do not get any support thus contributing to their traumatic stress. As a result of inadequate social support, heterosexual men are often highly depressed after the death of their partners.
Heterosexual person’s workplace discrimination is an important factor in terms of socioeconomic status. In most cases, they are often discriminated and treated unfairly in the work place environments. Most of them are poorer than the general population despite their high levels of education (Quintana, 2009). This is what makes them unable to get access to health care insurance cover. In conclusion, homeless people are characterized with higher mortality rates and poorer health. In addition to that, HIV/AIDS prevalence among this population varies widely. Hence, the need to come up with effective prevention activities for homeless individuals suffering from HIV. As such, various organizations should address various survival needs such as income, adequate nutrition and regular health checkups among homeless populations. These will enhance the survival of heterosexual individuals as they are faced with both financial and non-financial barriers.
References
Cousineau, M.R. (2007). Health status of and access to health services by residents of urban encampments in Los Angeles. Health Care Poor Underserved, 8 (1), 70–82.
Hwang, S.W. & Dunn, J.R. (2005). Homeless people: Populations, methods and practice. New York, NY: Kluwer-Plenum.
Hwang, et al. (2010). Universal health insurance and health care access for homeless persons. American Journal of Public Health, 100 (8), 1454-61.
O’Toole, T.P., Arbelaez, J. & Haggerty, C. (2004). Baltimore Community Health Consortium: The urban safety net can it keep people healthy and out of the hospital? Urban Health, 81(2),179–190.
Quintana, N.S. (2009). Poverty in the LGBT Community. Web.