Comparison Of The Impacts Of Social Determinants Of Health In The Context Of HIV/AIDS In Thailand And Australia

Discussion

Health is the most important element of human life. In order to attain overall mental and physical wellness, it is important to understand different factors related to health. All the factors contribute to the overall well-being of an individual. Health is related to lifestyle of a person as well. Every country is having different climate and cultural atmosphere due to varied geographical position and population. As a result, the lifestyle of the countrymen is affected making an impact on their physical and psychological wellness. There are a number of social determinants which are responsible for impacting the health of an individual. Those are social justice, gender, stigma and discrimination, economics, education, and healthcare systems. The impact of the major social determinants are compared and contrasted in this essay in the context of HIV/AIDS. This essay will be reflecting the situation of Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) in Thailand and Australia along with the comparison of the impacts of stigma and discrimination, and gender on the sex workers in Australia and Thailand in the context of HIV/AIDS. When a person is affected by Human Immunodeficiency Virus (HIV), the person develops a number of illnesses which are altogether recognized as AIDS or Acquired Immunodeficiency Syndrome (Whiteside, 2016). In Australia, the occurrence of HIV/AIDS is moderate. Further discussion will reveal more important aspects of the occurrence of HIV/AIDS in the country.

HIV/AIDS is a common disease which is found in every corner of the world. As the HIV virus is transmitted through blood and sexual discharges, the disease has taken a massive form. As there is no permanent cure for HIV/AIDS, the affected people continue to live with fear. There were approximately 26,444 HIV positive people living in Australia in 2016. 89% of these people were diagnosed at the last quarter of 2016. According to previous researches, it has been found that 95% of these affected people have got access to proper care, 86% of which are getting appropriate treatment of HIV (Reniers & Hosegood, 2014). Among the people who are getting treatment, 93% of them had undetectable viral load.

Table 1

Therefore, it can be easily attributed that HIV/AIDS is a common disease among the sex workers in Australia. As it is seen in table 1 that gay sex causes the most number of HIV/AIDS affected people in the country, the male sex workers are at higher risk of being diagnosed with HIV/AIDS. Meanwhile, the number of HIV positive female sex workers is extremely low (Davey, Cowan & Hargreaves, 2018). The scenario is quite similar in Thailand as well. Here, the early victims of HIV virus were gay men (Beyrer et al. 2015). Afterwards the virus gradually targeted the injected drug users and the prostitutes. The most number of people living with HIV in Asia Pacific are in Thailand. Majority of population are HIV positive, especially the sex workers. Male sex workers are more affected than the female ones. As per as survey conducted on 2016, a total of 450,000 people in Thailand are living with HIV/AIDS.

Selected Social Determinants: Gender and Stigma/Discrimination

One of the chosen social determinants is gender, which makes significant impact on sex workers with HIV/AIDS. Australia and Thailand belong from different continents, but the rates of HIV prevalence in both the countries are astonishing. Especially the sex workers of these countries have suffered or are suffering most from this deadly infection. As HIV/AIDS is a sexually transmitted disease, hence, it is evident that the sex workers would be at higher risk of coming in contact with the virus. In Australia, 70 per cent of the total HIV/AIDS affected population have acquired it through sexual contact between men (Holt et al. 2015). Sex between men and women had resulted in 21 per cent of the total cases of HIV/AIDS. Gay sex is considered to be one of the primary reasons behind the higher number of HIV positive sex workers in Australia. The country is having a vast number of sex workers living with HIV/AIDS, most of them being men. The number of HIV positive female sex worker is comparatively lower in the country. The survey conducted between 2006 and 2010 shows that 68% of the total HIV/AIDS cases were caused from gay sex. The HIV prevalence among female sex workers is as low as 0.037% (Tokar, Broerse, Blanchard & Roura, 2018). The pattern is not much different in Thailand. In Thailand, male sex workers are more likely to be found HIV positive than that of the female sex workers. According to researches done in 2014, among the 147,000 sex workers of Thailand, 12% of male sex workers and 1% of female sex workers were suffering from HIV/AIDS (Phuengsamran, Nittayasoot & Thammawijaya, 2018). The country has got highest number of HIV positive sex workers. Lack of HIV testing had led to increased number of HIV affected female sex workers in Thailand. The UNICEF study of 2015 had found that 31% young female sex workers of Bangkok and 50% young female sex workers at Chiang Mai had got proper education and services related to HIV for a long time span of 12 months (Bekker et al. 2015). The most at-risk group of sex workers globally are the transgender people. Gender, thereby, plays a pivotal role in determining the HIV prevalence among sex workers of Australia and Thailand. Most of the HIV affected sex workers are found to be male. In the meantime, HIV prevalence is extremely low among female sex workers. Male-to-male sexual contact is considered as the primary cause behind this pattern.

Gender’s Impact on HIV Prevalence among Sex Workers in Australia and Thailand

Another significant social determinant is stigma and discrimination. When it comes to HIV/AIDS, the infected people were discriminated. Although the situation has changed in certain countries, still most of the countries are yet to overcome the issue. In Australia, the HIV affected sex workers face a vast amount of discrimination as the country criminalises the HIV affected sex workers. The country is having a number of relevant policies regarding anti-discrimination in this context. Lack of proper campaigns spreading information related to HIV/AIDS has led to growing fear among the countrymen regarding the disease. Australia is having a history of stigma and discrimination towards HIV positive sex workers. An HIV positive sex worker was jailed in 2008 in Australian Capital Territory (ACT) for rendering sexual services to clients despite of knowing about the illness (Jeffreys, Matthews & Thomas, 2010). There was no evidence of unsafe behaviour from the part of the sex worker. Clearly, it is regarded as a case of discrimination. The action was criminalised by ACT laws just because the sex worker continued providing services even after being diagnosed with HIV/AIDS. Hence, it was concluded that the person is knowingly causing harm to society and its people. As a result, the sex workers became fearful to visit clinics. They feared that if they are diagnosed with HIV/AIDS they would not be able to provide services to their customers (Bolsewicz, Vallely, Debattista, Whittaker & Fitzgerald, 2015). The reduction in number of sex workers visiting healthcare centres led to more complex situation in this context, making the sex workers more prone to this deadly infection. As the people are mostly ignorant about the transmission process and treatment procedure of HIV/AIDS, they tend to discriminate the affected people. In Thailand, the male and transgender sex workers suffering from HIV/AIDS face massive stigma and discrimination (Smit et al. 2012). The male and transgender sex workers are unable to access proper healthcare services and treatment as they are excluded from their respective communities. They face great difficulties to get access to proper healthcare facilities which lead to increasing rate of HIV prevalence among them. As high level of discrimination and criminalisation are involved, the male and transgender sex workers are at greater risk of being infected with HIV/AIDS.

The Australian sex workers’ association ‘Scarlet Alliance’ assessed the needs of the HIV positive sex workers living in Australia in order to arrange proper healthcare services for them by preparing an evidence based report regarding the same. This reflects that proper education and healthcare services are required for the sex workers in Australia and Thailand so that they are free from stigma and discrimination. The gender is a key factor in this context and it is mandatory to bring gender equality in this field. The healthcare equality is also a significant aspect that could enhance their access to healthcare and enhance their quality of life. A male sex worker should be regular with needful health check-ups in order to stay healthy and safe from HIV/AIDS and any other illnesses. Condoms must be available to the sex workers so that transmission of HIV/AIDS can be reduced at a greater extent (Jin et al. 2015). Sex education is a must for sex workers along with education regarding HIV/AIDS. Moreover, strict laws should be passed to remove stigma and discrimination so that HIV infected sex workers get proper treatment.

Stigma and Discrimination against HIV Positive Sex Workers in Australia and Thailand

Conclusion: Sex workers are most vulnerable to HIV/AIDS and they must adopt precautions to stay safe from HIV infection. This essay is based on HIV/AIDS affected sex workers. In different parts of the essay comparison between the HIV infected sex workers of Australia and Thailand is reflected. The contrast between the HIV affected sex workers of both the countries are supported by major social determinants of the same. The role of gender and stigma and discrimination in the HIV prevalence among sex workers of these two countries are discussed briefly along with proper evidences. The essay also identified that education is an important factor that can help in reducing the prevalence of HIV/AIDS, as it can help them to get sex education, maintain safety and prevent sexually transmitted disease.

References

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