Introduction
Health Promotion: Significance
Although the concept of sexual health incorporates the elements of a vast range of domains, including not only physical but also emotional and psychological ones, there is a tendency among the general public to view the subject matter primarily as the avoidance of contracting sexually transmitted infections (STIs) (Marin et al. 2015).
Because of the specified misconception, the promotion of sexual health becomes excessively difficult in a range of communities (Marin et al. 2015). The fact that the nature of issues associated with sexual health is very sensitive also prevents the broad discussion of the issue and the identification of viable solutions (Duff et al. 2015). Herein lies the significance of developing a program for promoting sexual health. The identified step is expected to reduce a range of stereotypes linked to sexual health, as well as subvert the myths that prevent people from managing their sexual health appropriately (Duff et al. 2015).
One might argue that the promotion of sexual health has become easier with the advent of IT tools and eh introduction of ground-breaking technologies enhancing communication (Duff et al. 2015). However, while the specified tools can be used to boost awareness levels among vulnerable populations, the target demographic also needs guidance from healthcare practitioners and nurses to distinguish between valuable health-related information and biased data that may potentially harm them (Marin et al. 2015).
Thus, additional tools for encouraging communication between community members and nurses to promote appropriate sexual behaviours and acquire crucial skills are needed. By shedding light on some of the modern concerns, such as the sex work industry and the related threats, one will be able to prevent a range of health problems.
Sex Workers Industry: A Contemporary Health Concern
Because of the stigma mentioned above, the problem of sex health workers and the sex work industry, in general, as a health concern is usually overlooked by general audiences (Ulibarri et al. 2015). However, the needs of people working in the specified area have to be taken into account since sex workers tend to be underserviced in respect to healthcare services and, thus, pose a significant health threat to the rest of the population (Ulibarri et al. 2015).
Particularly, the fact that the health threats associated with the sex work industry are often dismissed as invalid discussion topics implies that general public who may come into contact with sex workers may also be jeopardised (Ulibarri et al. 2015). Thus, addressing the issue is essential for the further improvement of health management processes in the context of the contemporary social environment.
Particularly, there is evidence that sexual health workers may produce extensive risks for the rest of the community since social stigma increases the threat of sex workers contracting HIV/AIDS massively (Benoit et al. 2018). In addition, there is a possibility to become a victim of forced prostitution in the contemporary sex work industry, which affects not only physical but also the mental health of sex workers greatly (Benoit et al. 2018). Finally, the lack of awareness regarding major health concerns, tools for preventing the development of health issues, and the right to receive information about health management can be deemed as the primary areas that need to be managed.
Issues to Be Discussed
Addressing the problem of health awareness is the first step toward discussing the modern sex worker industry as a health issue. By focusing on health problems faced by sex workers, one will be able to minimise the threat that sex workers pose to the well-being of the rest of the population. Because of the absence of health literacy among the majority of sex workers, the levels of contracting STIs, especially HIV/AIDS are very high (Benoit et al. 2018). Therefore, tools for encouraging health workers to engage in the active acquisition of the relevant knowledge and skills, as well as providing the target demographic with access to required information, is crucial.
The problem of preventing the instances of forced prostitution in the context of the modern sex work industry and the management of forced prostitution victims’ needs should also be considered the focus of public health figures’ attention. Because of the lack of awareness mentioned above, a large number of people are forced into prostitution, experiencing psychological traumas and physical health problems as a result (Benoit et al. 2018). The program that is expected to manage the specified problem will have to focus on both raising awareness and providing counselling services to the victims of forced sex labour (Benoit et al. 2018).
Background
Sexual Health Promotion: Definition
The significance of sexual health promotion is truly ample since it allows maintaining people’s sexual health levels high. The phenomenon of sexual health is typically defined as the set of measures and strategies aimed at maintaining people’s sexual health at the required high levels (World Health Organisation 2017). The specified goal involves promoting sexual health awareness among the target population, offering relevant healthcare services, and keeping communication between nurses and communities consistent (World Health Organisation 2017). Therefore, sexual health promotion among sex workers will require utilising a range of communication tools for reaching out to the specified demographic and keeping them informed about essential information.
Rationale for the Choice
One might argue that the issue of sex workers is not related directly to public health since the specified industry is isolated from the rest of the community and, thus, ostensibly has little to no effect on it. However, on closer inspection, one will find out that the health issues faced by sex workers are linked directly to the problem of human rights infringement. Being entitled to the same range of rights and freedoms, sexual health workers are often marginalised and ostracised to the point where they cannot use health services and, thus, are isolated from the essential information that could help them retain their health (Marin et al. 2015). According to the existing statistical data, “The clients of sex workers act as a ‘bridge population’, transmitting HIV between sex workers and the general population. High HIV prevalence among the male clients of sex workers has been detected in studies globally” (AVERT 2015, para. 34). Thus, resolving the problem should be recognised as the issue of huge importance.
Main Body
Outcomes of the Problem: Sex workers and Health Concerns
The lack of sexual health awareness leads to a range of drastic outcomes among members of the sex work industry; furthermore, the problem also affects the rest of the community. For instance, a steep rise in the number of instances involving the contraction of STIs and, particularly, HIV/AIDS, is currently observed on a global scale as a result of the lack of awareness among sex workers (Benoit et al. 2018). The problem of HIV/AIDS development and contraction is also particularly topical for members of communities where basic healthcare services are unavailable or barely accessible. For example, the issue of HIV/AIDS development and contraction is very common among African sex workers in the communities that are located in remote areas or can be described as rather poor and, thus, unable to use advanced healthcare services (Beyrer et al. 2015).
In addition, the problem has a drastic effect on the target population as well. The death toll among members of the sex work industry has been on the increase over the past few decades despite the introduction of innovative communication technologies that could have affected health literacy rates among sex workers (Ulibarri et al. 2015). Even though the number of victims of human trafficking has declined slightly, people that have suffered the ordeal of being forced into sexual labour have been experiencing significant health issues, including both physical and mental concerns (Marin et al. 2015). The levels of depression and the rate of suicidal tendencies among the specified population can be described as extraordinarily high, which means that an intervention is overdue (Mustanski et al. 2015).
The pressure of the social stigma, in turn, prevents sex workers from communicating with healthcare experts and developing the habits and abilities that could help them address and prevent the specified issues (Marin et al. 2015). Thus, when designing a program aimed at addressing the problems associated with the sex work industry, one must focus on the problem of ostracism experienced by the specified demographic as the primary reason for the absence of awareness to exist (Baral et al. 2015).
Therefore, the current unavailability of information has a tremendous negative impact on sex workers. However, apart from affecting the vulnerable population, it also impacts other community members. Particularly, there is a concern about the health issues that are linked to the sex work industry having a direct effect on the well-being of community members.
According to Goldenberg et al. (2015), the levels of HIV and AIDS contracting and development in the environment of the sex work industry may have a direct effect on the rise in HIV/AIDS development rates among community members. The problem grows exponentially in the areas of the sex work industry that involve homosexual and transgender people (Poteat et al. 2015). Because of the prejudices that are wielded against them in some parts of the contemporary society, the specified population is especially vulnerable to the lack of awareness in the identified area and the unavailability of necessary health services (Mustanski et al. 2015). Therefore, it is crucial to ensure the development of the program that could target sex workers and encourage the development of health knowledge among them.
Theories and Concepts of Sex and Sexuality
Theoretical perspectives on the phenomena of sex and sexuality are quite numerous, the most well-known ones being the theory of nature versus nurture (Dixson, Duncan & Dixson 2015). In an everyday setting, the terms of sex and sexuality are often conflated, yet these are separate notions that need to be distinguished to determine the strategies for addressing the identified sexual health issue.
According to the existing definition, the phenomenon of sex is typically referred to as the combination of physiological characteristics that determine one’s sexual identity and behaviour, therefore, allowing to term one as a male or a female (Mustanski et al. 2015). Sexuality, in turn, is determined as one of the core dimensions that characterise a person and embraces a wide range of notions from sexual orientation to beliefs, values, roles, and responsibilities that one accepts within a particular society based on one’s perception of their place in it (Dixson, Duncan & Dixson 2015).
Incorporating the specified notions into a theoretical framework will allow exploring some of the most complicated contemporary sexual issues, the dilemmas faced by sex workers in the context of the sex work industry being one of them (Goldenberg et al. 2015). The subject matter can be viewed from the perspective of essentialist theories, which view sexuality as an intrinsic concept that cannot be altered (Morandini et al. 2015). Since the identified theoretical approach gives people comparatively little agency in shaping their sexuality deliberately, it helps to understand the challenges faced by people representing non-traditional orientations (Morandini et al. 2015).
The theories that view sexuality as a socially constructed phenomenon, in turn, might be viewed as somewhat controversial since they could be used to argue that non-traditional sexuality can be acquired and, thus, shaped (Dixson, Duncan & Dixson 2015). However, the identified frameworks can be utilised to encourage the target population, i.e., workers in the sex work industry, to alter their behaviours and acquire the knowledge and skills that will help them build awareness and identify threats to their health. Particularly, cultural factors that may contribute to the development of potentially dangerous behaviours can be identified and removed successfully, thus, leading to the acquisition of required habits by the target population.
These cultural factors include religious beliefs and social principles based on which sex workers are placed at the bottom of the societal hierarchy (Pitpitan et al. 2016). As a result, sex workers will not expose themselves to the same extent to a wide range of STIs and especially to the threat of contracting HIV/AIDS. It is remarkable that the identified attitudes within modern society, particularly, the societal contempt for sex workers that is currently becoming increasingly high, do not prevent community members from contracting STIs from sex workers (Dixson, Duncan & Dixson 2015). The theoretical framework in question will be especially important in addressing the problem of prejudices and misconceptions that swarm in the realm of the sex work industry and affect the quality of its workers’ lives significantly.
Health Promotion Models and the Sex Work Industry
Encouraging a change in sexual behaviours is especially difficult when promoting it in the context of the sex work industry due to the shift in priorities among most of its workers (Pitpitan et al. 2016). The unwillingness among sex workers to recognise the necessity of protecting oneself against STIs and HIV/AIDS is a common problem that defines the failure of health-oriented programs in the identified environment (Dixson, Duncan & Dixson 2015). Therefore, the health promotion models that can be characterised by their persuasive nature and the active dissemination of information must be regarded as essential at this point.
To handle the problem that can currently be observed among sex workers, one will have to apply Caplan and Holland’s Model (Hollands, Marteau & Fletcher 2016). Although being comparatively new, it has already warranted its existence by combining the theory of knowledge, the opportunity to generate the said knowledge among the target population, and the reconsideration of the role that society plays in the promotion of health. The significance of Caplan and Holland’s Model (CHM) is justified by the fact that it helps manage the societal contempt that sexual health workers have to face. By subverting some of the prejudices against sex workers, CHM will provide an opportunity to offer the target demographic informational resources that they will use to build a system of health knowledge.
As a result, the means of reducing the levels of mortality and contraction of STIs, including HIV/AIDS, will be located. The significance of health literacy on the specified changes is not to be underrated. By encouraging the target demographic to develop healthy behaviours and learn more about sexual health, one will be able to reduce the threat of people contracting STIs from sex workers. Therefore, the emphasis on health literacy allows introduction the principles of proper sexual behaviour. In addition, the specified change will help enhance the levels of health literacy among sex workers, thus, leading to a steep drop in the threat of contracting STIs among them.
Policies and Interventions: Existing Solutions
It would be wrong to claim, however, that no policies have been developed to support sex workers. Although most of these solutions, which primarily involve close supervision of sex workers’ health, turned out to be lacking in efficacy, there are ideas that can be used to promote proper healthy behaviours among the specified demographic. For example, one must give credit to the initiatives such as the Health Policy Project, which encourages multispectral cooperation as a possible solution to the steep rise in HIV/AIDS rates among the members of certain communities (Health Policy Project 2011).
The idea of inviting experts from different areas to work on the solution of the problem seems a very legitimate step to take given the wide array of factors, including clinical, nursing-related, medical, social, technological ones, etc., that define the absence of access to healthcare services and information for sex workers (Fehrenbacher et al. 2017). However, other options must be sought to improve the current situation. To be more accurate, one will have to focus on the development of a communication system that will reduce the levels of social ostracism experienced by sex workers.
The effects of dehumanisation experienced by the identified population have led to a drastic drop in their willingness to acquire relevant knowledge about sexual behaviour, threats to their health, etc. (Pitpitan et al. 2016). Consequently, the enhancement of social support should be viewed as one of the primary goals along with the overall rise in the amount of available data and services (Denno, Hoopes & Chandra-Mouli 2015).
Culture, Ethics, and Religion: Impact on the Problem
The effects of sociocultural factors on the issues faced by sex workers are not to be underrated, either. Being a highly taboo topic in a range of cultures, the contemporary sex work industry incorporates a range of controversies that cannot be discussed due to the restrictions created by the societal norms. For example, since the provision of sexual services is deemed as sinful in most religions, the threats that sex workers face on a regular basis, including violence, exposure to a range of STIs, human trafficking, etc., is silenced (Denno, Hoopes & Chandra-Mouli 2015).
As a result, the problem cannot be addressed and, instead, aggravates consistently. For instance, being silenced for the most part, the issue of human trafficking in the sex work industry is taking an increasingly large scale (Denno, Hoopes & Chandra-Mouli 2015). Similarly, the culture that views an open conversation about sexuality as inappropriate and even deviant poses a range of obstacles on the way to addressing some of the most problematic aspects of sex workers’ life (Denno, Hoopes & Chandra-Mouli 2015).
Therefore, the active promotion of a more appropriate set of values that send the message of every person being entitled to the same rights and opportunities should be seen as an essential step toward improving the current situation. The specified goal aligns with the definition of sexual health provided by the World Health Organisation (2018). According to the definition provided by WHO, sexual health can be defined as well-being in all areas including mental, physical, and social health:
Sexual health is a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. (World Health Organisation 2018, para. 1)
By focusing on altering the existing concept of social justice, one will help make sex workers visible and relieve them of the stigma that they currently bear. It is expected that the specified change will allow challenging the existing perspective and reinforce the process of knowledge dissemination among the identified population. Furthermore, it is believed that a change in the social perspective will lead to alterations in the legal area and, which is nonetheless important, provide sex workers with direct access to healthcare services. The identified changes will imply that not only will sex workers be provided with assistance and consultations regarding sexual health issues, but also have an opportunity to receive legal protection against the threat of being forced into sexual labour (Biello et al. 2014).
The use of legal changes will imply tougher standards for health in the realm of the sex work industry. Consequently, the threat of contracting STIs from sex workers will be reduced significantly. In addition,, legal restrictions will help reduce the number of instances of human trafficking and other illegal activities that affect the sexual health and behaviours of sex workers. Thus, the latter will not be exposed to the threat of STIs and, consequently, will not pose a danger to the rest of the community. Finally, the proposed framework will allow the victims of sexual violence in the sex work industry setting gain a voice and receive the psychological, medical, and emotional assistance needed to overcome the trauma.
Conclusion: Sex Workers and Health Issues Management
Summary
Although the issues faced by people working in the sex work industry are often silenced due to the controversy of the topic, health concerns that sex workers experience must be addressed since the identified population is entitled to the same right to receive proper healthcare as the rest of the population. At present, the array of health problems that the specified population has is massive, ranging from STIs and HIV/AIDS to the possibility of being forced into sex labour and experiencing sexual violence (Beyrer et al. 2015). The consequences of the specified phenomena are truly dire, extending to not only physical damage but also psychological and emotional scarring.
Furthermore, the lack of availability of essential health management opportunities for the specified population aggravates the problem, leading to a steep decline in the overall health levels among sex workers (Mustanski et al. 2015). The existing solutions to the dilemma involve primarily the campaigns that are aimed at building awareness among sex workers, which might seem as a legitimate response to the issue.
However, since the concern is rooted deeply in societal, economic, and cultural issues, it is crucial to design the program that could help build awareness among community members as well as sex workers along with the provision of information and health resources to the latter. As a result, the degree of social isolation experienced by the vulnerable population in question will be reduced significantly. Furthermore, the problem will finally be recognised and discussed, possibly leading to a drop in the levels of human trafficking, violence against sex workers, etc. The degree to which prejudices affect the access to healthcare for the specified demographic is also expected to decrease.
Recommendations
At present, a program aimed at building awareness among sex workers and community members alike is overdue. The process of dehumanising the identified vulnerable population must be stopped to address the problem efficiently. The specified demographic needs the support of the society to fight the injustice that they face. Moreover, it is strongly recommended to seek further ways of improving communication between sex workers and healthcare providers. Thus, the former will be provided with up-to-date information about current health issues, the tools for addressing them, and the ways of detecting a threat to their health.
The following increase in the number of positive outcomes and prevented health issues, especially the contraction of STIs and HIV/AIDS, can be expected as the likely outcome. However, for the program to become successful, it will be crucial to subvert some of the contemporary prejudices against sex workers, which will require transcending the boundaries of culture and religion. Therefore, the focus on a rational dialogue and the concept of basic human rights will have to be maintained to alter the current idea of social justice in regard to sex workers. As a result, a gradual improvement in health rates among the specified demographics will be possible.
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