Individual Essay on Social Determinant of Health

Running head: Individual Essay on Social Determinant of Health
Individual Essay on Social Determinant of Health
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Individual Essay on Social Determinant of Health
According to the World Health Organisation (2019), Human Immunodeficiency Virus
(HIV) aims at the immune system; thus, weakening the defence system against infections and
cancers. The virus is responsible for impairing the ability of immune cells to act, making the
people immune-deficient. AIDS is defined as the progress of infectious disease, tumour and
other clinical outcomes. The transmission of HIV/AIDS among men having sex with men
(MSM) is through sexual practice. The aim of the essay is to understand the difference in the
influence of two social determinants of health, gender, stigma and distinction of HIV among
MSM in Australia and South Africa.
According to the study conducted by Kutner, Nelson, Simoni, Sauceda and Wiebe
(2017), MSM that had protection-less sex with a serodiscordant mate were conveyed to have
transmitted HIV as a result of which the possibility of anxiety, stress and other worse health
outcomes were detected. The early record of HIV contamination in South Africa was in the
1980s, where different HIV-1 was identified among this specific group. However, due to
ignorance of the vulnerable group by the government, the estimation of the MSM population
suffering from AIDS does not exist. It was found that 13.2% of MSM and 33.9% of gay men
were HIV positive in the Africa areas (Sandfort, Knox, Collier, Lane and Reddy, 2015). In
2014, approximately 1.4 million MSMs between the age ranges of 15 to 49 years were
affected. According to Cheung et al., (2016), the percentage of people who have HIV in
Australia is increasing, and most important risk for HIV is a receptive and unprotected sexual
relationship that included ejaculation with their normal partners. Approximately 27545
people are affected by HIV and 89% can be contributed due to male-to-male sexual in 2017
(Afao.org.au, 2017).
Gender has been recognised as one of the most critical determinants of health as there
are various factors that negatively influence the accessibility of health services and there is a
varied response of health system to different types of vulnerable groups. The two dimensions

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Individual Essay on Social Determinant of Health
that were responsible for recognising gender, as important health determinant was gender
inequality and addressing the norms and role of gender in gaining a better consideration of
social construction with respect to identity. According to Quinn et al., (2018), gender is stated
to have expectations and roles credited in case of both men and women in the community
over the different phases of life. Gender is considered as a social construct rather than
biological and varies from time, values and norms in the society. Maleke et al., (2017) opined
that despite technological and medical advancement, HIV/AIDS had been a crucial public
health issue in South Africa. It has a disproportionate impact on socially vulnerable groups,
especially MSM. The occupational and behavioural roles were restricted in term of social
norms had delineated the association of health and gender in South Africa (Daniels et al.,
2017). In this particular case, the impact of gender is stated to be an intricate aspect that
involves autonomy, poverty, power or authority and marginalisation across different culture
and societies, thus, increase the chance of acquiring HIV. In the case of Australia, the
vulnerable group is more acceptable and recognised as compared to South Africa, a result of
which, the rate of AIDS-affected people is more accurate in nature (Jobson et al., 2018). The
health outcomes of MSM in Australia were more effective because of positive socioeconomic
factors that promoted early identification and prognosis of the disease. Therefore, gender is
not a basic factor in this case, as men having sex with men, as the consequence of gender in
the society at each level is found to be less tangible in nature.
The second social determinant of health concerning HIV that can have an influence
on MSM in both Australia and South Africa is particular in term of stigma and
discrimination. As per the opinion of Hatzenbuehler, Phelan and Link (2013), specific
stigmatised status have been developed in a specific domain. Stigma is associated with
various kind of diseases such as mental illness, sexual preference and development of AIDS
that is subjected to discrimination and thus, is a cause of stress in the specific vulnerable

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Individual Essay on Social Determinant of Health
groups. As per the studies, it was observed that MSMs are subjected to harassment and
discrimination as compared to other vulnerable groups that are engaged in sexual interaction.
The risks factors that are associated with such group of people involve violence from family
members, society and other sources that affect their health and well-being. The primary
method of spread of HIV in sub-Saharan Africa is heterosexuality and thus, focus on MSM is
rare. As per the study of Kerr, Northington, Sockdjou & Maticka-Tyndale (2018),
internalised stigma is found to be high among men suffering from HIV. The HIV-positive
MSM has been reported to be a group that suffers from a high level of social isolation and
discrimination because of loss of employment or housing. The social stigma toward the gay
community has led to such issue that the group do not disclose their health status. On the
other hand, HIV-related stigma and discrimination had been one of the significant issues
among people residing in Australia (Community Led Efforts - Stigma and discrimination -
Australian Federation of AIDS Organisations, 2020). It has been experienced in various
settings such as general, healthcare and gay community as well. Australian society is more
open as a result, the statistics related to HIV affected people among the men having sex with
men is more prevalent and open. It had harmed the people thus, affecting the well-being as
well as the quality of life. Therefore, it had reduced the treatment, testing and retention
facilities in the care process.
The recommendations that can be adopted to reduce the negative impact of gender-related
and social stigma and discrimination among HIV-affected MSMs are the acceptance of the
society in accepting the vulnerable groups and open discussion about the risk factors
associated with the group. The investment needs to be done in order to improve the poor
health outcomes among HIV-related MSM thus, reducing the discriminatory aspects in
primary care settings as well as awareness of the risk factors associated with this particular

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Individual Essay on Social Determinant of Health
group. The awareness of the risk factors and the issue that the vulnerable group might face
and motivation to share their issue and health problem need to be done.
From the essay, it can be concluded that the MSM group is one of the most vulnerable
groups that are affected by HIV. The two most critical social determinant of health that had
been taken into consideration were gender, stigma, and discrimination that had been focused
on two specific countries, South Africa and Australia to exhibit the variation of health
outcomes related to one of the most critical public issues, HIV/AIDS. It was found that
societal acceptance of HIV-positive MSMs was similar in both the countries; thus; the
accurate statistics are not available. The recommendation involves acceptance of the
community in the society, which will help in increasing the awareness about HIV among
those people as well as better accessibility of healthcare provision to them.

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Individual Essay on Social Determinant of Health
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