Challenges to Sexual Health Care in Todays Society

Challenges to shake upual Health kick in Todays SocietyMeeting the informal health demands facing matchless-year-old people in todays societyThe issue of cozy health in boyish people is a vast topic with an associated vast books on the subject. In this essay we aim to consider some of the study themes and critically analyse some of the peer reviewed literature to act as an evidence base for further amity. (Berwick D 2005)In broad ground, end upual health rotter be divided into argonas of physical health and stimulated (or psychological) health. The adolescent days is classically one of tumultuousness, of establishing identity, values and ideals. This is arguably the snip when the emotional turmoil relating to sexual identity comes to the fore.We should remind ourselves, in the first place perhaps dismissing the nonion of psychological health as being on a different level of seriousness as an overtly physical line such as a sexually transmitted sickness, (Coyle KK et al 2001), that one of the comm further accepted definitions of health is a state of complete physical, manpowertal, and fond well being, and not just merely the absence of disease or infirmity. (UN 1995). unitary good deal argue that it is an essential component part of the under separateed persons ability to become well adjusted, responsible and successful (in every sense of the word) members of society (UN 2002)Issues of sexuality chip in, ideally, to be resolved. The appargonntly imperishable adolescent dilemmas of am I sexually attractive? am I gay or straight? or am I piece to corroborate sex? weely have a direct relevancy to the psychological health of a person exclusively the conduct patterns that these questions bottom of the inning engender in an attempt to resolve them, can pose clear risk patterns to the physical sexual health of the adolescent. (Larson, R., et al. 2002.)To a large design the issues that concern the adolescent have their origins in ea rlier life. As they keep through childhood, adults treat boys and girls differently, and thereby establish different expectations for their behaviour. These expectations are all the way influenced by their culture and a myriad of more subtle influences. They for the or so part determine life placecomes. They to a fault shape the adolescents display to sexual conventions, sexuality and relationships generally. (Aarons SJ et al 2000)The reason for dwelling on these situationors is that they have a rudimentary bearing on the possibility of adverse reproductive and sexual health outcomes in later life, including events such as unsought gestation period, unsafe abortion and sexually transmitted diseases, all of which have major socio-economic components. (Churchill D et al 2000), Differential gender expectations and social treatment in childhood and the early adolescent period are thought to be frequent causal itemors in adolescent problems.The bulk of this essay testament be on the issues surrounding the major issues of STDs in the adolescent community. One of the most pressing issues in this count on (at least in cost of sheer numbers) is the issue of chlamydia. (Fenton KA et al 2001). In the specific terms of face-off the demands of the adolescent population we lead begin this examination with a consideration of the National Chlamydia Screening programme.The programme was originally set up afterwards the realisation that chlamydia was responsible for a large amount of morbidity in the community which had, hitherto been unrecognised (Cates W, et al. 1991). It is now clavern as the single most commonly transmitted STD in the UK today. A huge proportion of what use to be called NSU is now recognised as being cod to the chlamydia pathogen (Duncan 1998).If we consider the issues behind the cover programme, on one level the issues have the appearance _or_ semblance fairly straightforward and simple. Because we know that ump young cases of chla mydia are a characteristic and that it can cause considerable dam season and that it is also easily treatable, why not screen for it and minimise its impact? (Kufeji O et al 2003)On a more sophisticated level one must consider the cost- efficaciousness considerations together with issues such as feasibility, efficiency and use of resources.If we examine the published rule behind the National Chlamydia Screening programme as set out by The National Institute for Clinical Excellence (NICE) we can see that it states thatGenital Chlamydia trachomatis is the commonest Sexually genetic giveion (STI) in EnglandGenital chlamydial contagious disease is an important reproductive health problem 10-30% of infected women develop pelvic inflammatory disease (PID).A significant proportion of cases, peculiarly amongst women, are asymptomatic and so, are liable to remain undetected, putting women at risk of developing PID.Screening for venereal chlamydia transmittance may scale down PID an d ectopic pregnancy.They also concluded that there was not a great deal of data on the cost effectiveness of the possible procedure ( elicit et al 1994)The writing itself is extremely detailed and, in essence, it points to the point that it is extremely cost effective to detect and treat asymptomatic patients forrader they develop complications that then hold treatment. Complications are outlined in the paper by Berry (et al 1995) and include the sequelae of infertility, pelvic inflammatory disease and ectopic pregnancy in women together with the complications that can occur in the male partners (infertility and prostatitis).The authors point to the fact that their check programme reduced both(prenominal) the incidence and prevalence of pelvic inflammatory disease by 60% when compared to the unscreened population. Of particular relevance to our theme, we note that the natural covering programme became cost effective when the incidence of infection in the population of asympt omatic women rose higher up 1.1%. Figures quoted by Pimenta J (et al 2001) suggest that in our fanny age assert the prevalence is approaching 11%.If we examine the literature on the subject we can see that the adolescent age range has the fastest growing proportion of chlamydial infections (Gilson et al 2001). This finding is and then at odds with the logic of the report commissioned by the old judgment of convictionr Medical Officer (CMO 1998) which suggests that the groups to be screened under the National Programme should beEveryone with symptoms of chlamydia infection,All those attending genitourinary medicine clinics,Women seeking termination of pregnancy.opportunist covering of young sexually active women under 25 huge timeWomen over 25 with a new sexual partner or two or more sexualpartners in the past year.It will therefore be immediately apparent that there is no supplying for screening for asymptomatic men and also that the adolescent population are not to be speci fically showed unless they attend clinics.On the subject of screening young men, there are a number of well write papers on the subject. Notable amongst them is the Duncan paper (Duncan et al. 2001) which looks at the issues of male screening from both a Public Health viewpoint and it also considers it from a feminist sociological angle which makes it, (in our examination of the current literature), almost unique.It is a thoughtful and well written document and tackles the thorny issue of the fact that many young women are reluctant to attend screening clinics as being screened for STDs has overtones and perception of being dirty and unattractive. A positive screening result can be associated with considerations of promiscuity. Such feelings are understandably counterproductive, oddly in the light of our earlier comments relating to the developing psyche of the adolescent. Duncan puts forward the speculation that by not screening men, it not only fosters gender inequalities, but it sends of forbid messages regarding the mans responsibility for sexual health (Pierpoint et al 2000).Critical analysis of this point suggest that although it may be intuitively true, the authors dont produce any counter evidence with regard to the cost effectiveness of screening adolescent males (or any other age group for that matter) in the population (Stephenson et al 2000)Other authors do also make the point that it appears to be a generally accepted fact that women are very easier to target than men as they tend to be heavier health care users than men in this age range (Stokes T 2000).The main practical thrust of this paper however, is in its call for a greater understanding of the womans point of view when organising and raceway screening clinics in order to broaden their appeal to the intended target groups (Santer et al 2000). Clearly this point is central to our considerations here as clearly there is no point in providing services to meet a perceived need if there i s no uptake from the targeted population.If we turn our financial aid to the second most common STD in this age range we need to consider venereal herpes. (Schacker T et al 2000)There are many common arguments in the areas of screening for genital herpes and chlamydia. Qualitative studies have shown a greater level of concern relating to genital herpes amongst the adolescent population that there is for chlamydia, and it is second only to humane immunodeficiency virus/ assist (Corey L et al 2001). The specific problem with the age range that we are specifically considering here is that there is a general perception that genital herpes is a nuisance and a comparatively trivial condition. Indeed the majority of infections are either mild or subclinical. Serious complications are actually comparatively common and there is an increasing physical structure of evidence that suggests that genital herpes infection is a potent facilitator of sexual transmission of the human immunodefi ciency virus virus. (Tripp J et al 2005)The major epidemiological factor that is relevant with genital herpes is the fact that transmission can occur in a long-standing monogamous relationship. Its immediate problem is that the longer the period of infectivity, the greater the strength for transmission. In the adolescent years when there is a greater likeliness of a number of sexual partners, infections can be contracted only to be passed on at a considerably later time due to the fact that subclinical or unrecognised reactivation in the infected partner is intermittent. (Hopkins J 2005)There is another element of sexual health that is specific to the adolescent age range. As we have already observed, adolescence is a time of considerable turmoil not only in terms of psyche but also in terms of hormones. There is an catchy paper by Brabin (2001) which considers the impact of fluctuating hormone levels on the bodys susceptibility to STDsIt is already established that sex hormones play a role in the hosts resistance to STDs (Hewitt RG et al 2001). We can show this by considering sex differences in susceptibility to infection, variations in the clinical manifestations of infection during the menstrual cycle (Greenblatt RM et al 2000) and also during pregnancy (Brown ZA et al 1997) and also by the fact that the OC Pill predisposes to some infections (Wang CC et al 1999)The paper considers the implications of these facts with particular reference to the adolescent age group. It points to the sex differences in the acquisition of STDs with the adolescent girl getting infections such as genital herpes and chlamydia with greater frequency than the adolescent boy. (Obasi A et al 1999)Sex differences also have an effect on the force of a genital herpes vaccine trial which showed a limited protective efficacy against genital herpes in women but none in men. (Stephenson J 2000).The whole area of the ability of the NHS to meet the demands of the sexual health ask of t he adolescent is vast. We have not presumed to cover all of the relevant areas in this particular essay.In the areas that we have selected for examination and consideration we have been at pains to critically assess the evidence base as this is fundamental to the acceptance of the comparative validity of the various papers used.The adolescent age group has certain unique characteristics which set its sexual health cogitate problems apart from the rest of the population. In short, they can be encapsulated in the turmoil of the characteristic psychological and physical changes that are typical of the age. We have examined how the psychological issues impinge on both the sexual behaviour patterns and therefore the disease exposure risks and also the willingness to attend clinics if a sexually acquired disease swear out becomes apparent. We have contrasted this pattern with the pattern of screening that is currently advised and implemented under the auspices of the National Chlamydia Screening Programme. We have also examined the negative aspect of the disproportionate concentration of resources of the older female population and therefore, by inference, the impact that this will have on the adolescent population.Issues such as genital herpes also have unique implications for the adolescent, particularly with the long period of infectivity that is relevant to this disease process.We also have examined the implications of the hormonal differences that are amplified by the hormonal changes that are apparent in this age range.ReferencesAarons SJ, Jenkins RR, Raine TR, El-Khorazaty MN, Woodward KM, Williams RL, et al. 2000Postponing sexual intercourse among urban junior high school students. 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