Sexual Health and HIV in London Boroughs: An Urban Health Case Study

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SEXUAL HEALTH AND HIV: A CASE STUDY OF LONDON BOROUGHS
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SEXUAL HEALTH AND HIV: A CASE STUDY OF LONDON BOROUGHS
Introduction
Urban health is a burning issue in the 21st century. With the world moving towards a complete
industrialization and technological affluency urbanization has proved to be a major global trend
of 21st century. It is basically the health of the people living together in a certain incorporated
area like city or town with similar living conditions. Urbanization has a significant effect on
health. It is derived that 68% people of the world will have living in cities by 2050. There are
certain factors that affect the urban health of a given area. They are urban governance, natural
and artificial environment, services and health emergency managements, population
characteristics, social and economic development and food security (Harding-Esch et al., 2017).
Health Immunodeficiency Virus or HIV is a kind of virus that targets and damages the immunity
system of a person. These viruses’ attack immune cells called CD-4 and makes way for
opportunistic diseases to attack our body and weakens our immunity system. If not treated
correctly it can result in an advanced stage, AIDS.
This report will provide a detailed analysis of the concept of urban health, the chosen urban
health HIV, rationale of why HIV is an urban health issue, the urban context and determinants of
HIV based on London. Moreover, the Urban Health Profile of London, the identified and
explained consequences and implications of HIV, strategies and interventions to tackle the
problem, recommendations and the final conclusion are all drawn out on the whole report.
The Rationale of the Issue
Sexual Health is one of the most prominent urban health issues of London Boroughs due to the
fact that in light of the modern progressive social world, many people have become liberal in
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SEXUAL HEALTH AND HIV: A CASE STUDY OF LONDON BOROUGHS
their lifestyle. As such, they tend to be less conservative when it comes to meeting new people as
well as having physical relationships with them. From the research works of Liu et al., (2016), it
has been found that the modern lifestyle of the people of London Boroughs has been able to
contract many sexually transmitted diseases over the last few years. This resulted in the London
Boroughs having the highest rate of STDs and sexual health issues in all of England. In 2017
alone, cases of over 117,000 people being infected with STDs surfaced which represented a rate
of 1,335 patients in every 100,000 population. From 2016 to 2017 alone, the rate of syphilis
increased by 16% while that of gonorrhea rose by 23%. On the contrary, STDs such as
chlamydia, genital herpes, and genital warts decreased in contrast to other dangerous STDs. As
pointed out by Wright et al., (2017), out of the diagnosed STD infected patients of 2017, over
36% of the diagnoses consisted of people from the ages 15 to 24 year old.
Figure 1: Diagnosed STDs of London Borough
(Source: Wright et al., 2017)
From the research works of Sewell et al., (2017), it has been found that the main reason for this
target groups being heavily infected with STDs and facing sexual health is the fact that the
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SEXUAL HEALTH AND HIV: A CASE STUDY OF LONDON BOROUGHS
lifestyle that they are leading. It has been found that 9 out of every 10 people from ages 15 to 24
year old have experienced unprotected sexual contact with a partner of opposing or even the
same gender. As a result of this, contractual sexual diseases such as HIV, AIDS, gonorrhea,
syphilis, chlamydia, and many others are rapidly spreading throughout London Boroughs.
However, the most dangerous and incurable STD out of these is HIV which has affected the
sexual health of the people of London Boroughs heavily. As opined by Amin (2015), an
estimated 38,600 people are infected with HIV living in London Boroughs. However, one of the
most intriguing facts about the HIV infection in London Boroughs is that the majority of the
diagnoses depict HIV being more prevalent amongst gay and bisexual men in comparison to
heterosexual men from the ages of 15 to 60 years old.
Figure 2: HIV Diagnosed Rate Percentage in the UK
(Source: Amin, 2015)
From the research works of Cheung et al., (2016), it has been found that the number of patients
being infected with HIV is significantly increasing each year with the number has risen from
38,600 in 2017 to 40,000 in 2018. Moreover, HIV is one of the most deadly diseases in the world
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SEXUAL HEALTH AND HIV: A CASE STUDY OF LONDON BOROUGHS
that has no cure or remedy and as such, there is no way to completely cure the patients at all.
This has become a major sexual health issue not only in London Boroughs but also for the rest of
the world. Therefore, as pointed out by Hojilla et al., (2018), it has become a life-threatening
issue which not only destroys lives, but it also affects those around the infected individual. STDs
are very much problematic for people and can negatively affect the lives of the diagnosed
individual. This makes them experience a shift in their daily lives as well as in their mental and
physical well-being. However, due to the liberal and carefree attitude of the younger generation
people in London Boroughs, the spread of STDs has been an uprising. This has resulted in the
growth of HIV diagnosed people in London Boroughs who have their entire lives and career
ruined because of this STD.
Figure 3: Contemporary HIV Diagnosis of London Borough
(Source: Hojilla et al., 2018)
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SEXUAL HEALTH AND HIV: A CASE STUDY OF LONDON BOROUGHS
Urban Context and Determinants
There are certain factors which causes HIV AIDS. It is caused when the infectious virus is
transmitted to one person from another person. The agents that transmit the virus are:
 Saliva: This works as an agent when a non-infected person comes in contact with the
saliva of an infected person. The contact can happen while talking and majorly while
kissing. Apart from this, it can be also be transmitted if a non-infected person consumes
the left-over food of an infected person or while sharing the same utensils without
sterilizing them (Davis et al., 2016).
 Fecal oral route: This way the HIV virus is transmitted when there is traces of urine or
fecal matter on toilets and toilet seats. This is transmitted when washrooms are shared by
infected people. Apart from this it can also be transmitted through sexual contact.
 Cough: It is transmitted through cough if the infected person does not cover his/her
mouth while coughing. This leads to the direct contact of the person’s saliva with a non-
infected person spreading the virus.
 Used needles: HIV is spread through needles when reused. Needles are not supposed to
be reused. However, if a used needle on a HIV patient is reused on another person it can
transmit HIV.
 Blood Transfusions: The blood of a person contains the virus that causes HIV. Hence
blood exchange or any contact with blood of an infected person can transmit the disease
to another person.
 Sexual intercourse: This is one of the main reasons why HIV spreads. A sexual
intercourse causes HIV if the partner is a patient of HIV. Through the intercourse and
exchange of body fluids, the virus gets transmitted causing HIV.
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SEXUAL HEALTH AND HIV: A CASE STUDY OF LONDON BOROUGHS
 Infected mother to a fetus: A mother who is a HIV patient can pass on the disease to her
baby while birth. Due to the presence of the virus in the blood, it is passed on to the fetus.
Once a person is infected by the HIV virus, it has certain consequences on the person. These
consequences appear as the HIV virus attacks the immune cells of the body which otherwise
works as the defense system of our body against diseases and infections. The attacking of this
virus on the immune cells weakens the immunity system which reduces the ability of our body to
fight other diseases. This also affects the respiratory and cardio vascular system of the body. It
increases the risk of cold, flues and pneumonia. This can cause vital lung diseases (Bourne et al.,
2015). If not treated properly this can cause serious diseases like tuberculosis, pneumonia and
pneumocystis cariniipneumonia. Apart from this, it also affects the digestive system of the body.
A very common disease caused by HIV is candidiasis. HIV related nephropathy causes
inflammation in the filters of the kidney making it hard to remove wastes from the blood.
Problems in the digestive system can cause loss of appetite leading to massive weight loss. HIV
also causes certain serious neurological conditions in our body. Dementia majorly affects the
cognitive functioning of the body. Some other complications of AIDS are memory impairment,
anxiety, and depression. Advanced cases can cause hallucinations and frank psychosis. Some
people experience headaches, balance issues, and vision problems (Aghaizu et al., 2015).
The urban health profile of London is varied in nature if compared with the average of England.
This is closely related to levels of deprivation, which varies from several local authorities. The
city of London has certain local health priorities. They are mental health and well-being, work
place health and air quality. 10.8% children below the age of 20 were living in conditions of
poverty in 2013. About 46.8% adults in London were a victim of obesity in 2012-14 (Nanzayats
et al., 2016).
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SEXUAL HEALTH AND HIV: A CASE STUDY OF LONDON BOROUGHS
Figure 4: Urban Health Profile of London Boroughs
(Source: Nanzayats et al., 2016)
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SEXUAL HEALTH AND HIV: A CASE STUDY OF LONDON BOROUGHS
Figure 5: London Boroughs Deprivation
(Source: Aghaizu et al., 2015)
Impact on Health of Individual and Health Services
Sexual Health issue is one of the most challenging urban issues in the context of the modern
globalised world and as such, it has a prominent negative impact on the general population, on
the individual, and on the health services. HIV is a major issue within the STDs group that
affects the sexual health of an individual and also impacts the general population as well as the
health services. From the research works of García et al., (2017), it has been found that in the
context of the diagnosed individual, the impact is severe. STDs, especially HIV, affects both the
physical and mental aspects of the individual. While the physical impact is a direct effect of
being exposed to the disease, the mental impact is a side effect that builds up gradually in a
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SEXUAL HEALTH AND HIV: A CASE STUDY OF LONDON BOROUGHS
series of cumulative events in the life of the diagnosed individual. As opined by Pillay et al.,
(2018), HIV results in various physical symptoms such as weight loss, body pain, frequent
sickness or illness due to complete or heavily reduced immunities against diseases, fatigue, and
many more. This greatly shifts the individual from their normal daily life and impacts them
heavily. As a result of being diagnosed with HIV, the individual’s mental state shatters and he or
she is unable to socialize normally which results in them getting depressed as well as suicidal. It
has been found from the research works of Oster et al., (2016), it has been found that 32% of the
diagnosed patients have not told about anyone about their condition except for healthcare
professionals. 25% of the patients have required in disclosing their HIV status, 14% said they
feared being discriminated by others, and 4% said they have either refused or delayed their
medical treatment.
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SEXUAL HEALTH AND HIV: A CASE STUDY OF LONDON BOROUGHS
Figure 6: HIV Diagnosed Individual Population Density of London Borough
(Source: Oster et al., 2016)
Within the wider context of the impact of STDs, especially HIV, on the general population, the
issue has a similar impact in comparison to the individual impact. As opined by Dunn et al.,
(2016), HIV has created a profound impact on the general population since its discovery due to
the nature and lethal potency of the disease. As a result of this, the general population fear the
disease very much and try to avoid getting infected by it since the disease is completely
incurable. However, due to the fear and prejudice of HIV amongst the general population, the
individuals diagnosed with HIV are discriminated and mistreated badly. As opined by Muldoon
et al., (2018), due to the rumors and myth of HIV and its nature, most of the general population
that consists of people with lack of sufficient knowledge have mistreated HIV diagnosed
individuals. The main reason for this is the fact that the general population believes that they
could easily contract HIV from diagnosed individuals. This misinformation not only keeps the
general people in constant fear, but it also affects HIV diagnosed individuals.
On the health services, HIV has a prominent impact but which is less compared to the impacts on
the individual and the general population. From the research works of Bien et al., (2015), it has
been found that despite the advancements in modern technology and medication, there is still no
permanent solution or cure to HIV. While the majority of the STDs in the contemporary world
can be cured through modern medicines, however, HIV is one of those dreaded diseases that
have no cure. Contemporarily, there are many medicines that have been created in order to
mitigate the symptoms of HIV as well as delay the harmful effects of the virus in the diagnosed
individual prolonging or extending their life. As opined by Cheung et al., (2016), current health
services for the HIV only extends to such effects, however, efforts are still being made in order
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SEXUAL HEALTH AND HIV: A CASE STUDY OF LONDON BOROUGHS
to produce a permanent cure to HIV. Moreover, through the rapid progress of medical science
and technology, it is plausible that in the near future, the availability of the permanent cure for
HIV would be possible.
Figure 7: Continuum of HIV Health Care in London Borough
(Source: Bien et al., 2015)
Strategies and Interventions for Addressing Health Issue
The poor populations have more serious health issues and higher morbidity and mortality rate.
This is because of unequal opportunities and resources related to health and otherwise. This
prevails more in urban areas. Furthermore, organization of cities and management has a great
impact on health inequalities which contributes to reduce them. Health in urban populations is
shaped by municipal determinants and global trends. This can be tackled by various health
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