LGBTQ as an Emerging Population

Adolescent LGBT/STI

Although sexually transmitted diseases (STIs) affect individuals in all ages, they are particularly prevalent among young persons who include adolescents. In fact, young persons between 15 and 24 years of age account for just over 25% of the sexually active population, but account for 50% of new sexual transmitted infection (Montemayor, 2019). The present paper explores health care delivery approaches in managing among sexually active adolescent populations.LGBTQ as an Emerging Population

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  1. What more should you know about this situation?

A review of the case details reveals that Nancy is a sexually active adolescent who is a member of the LGBT community and is in a same sex relationship. She has been spending some of the nights with her partner, has no desire to have a sexual relationship with a member of the opposite gender, and is not on birth control. Still, there is a need for additional information to be collected in a health assessment. The first question to ask is what does Nancy know about sex and STIs. This forms the basis for the sex education as it determines what she already knows, whether what she knows is accurate or inaccurate, and what information should be provided to help her make the best decisions. The second question would be about whether or not Nancy has any question about her body and sex. This is important for making her comfortable with her body and sex, and enabling her to be more proactive in the health discussion. The third question would be how would she interpret her experiences in adapting to her body. This question acknowledges that Nancy’s body has undergone a lot of changes during adolescence and although this is normal, it can be confusing. Some adolescents feel that they are more of a girl or a boy, or even something else, even as their body changes in another way. It is important to know if she has the same experiences, and if she is struggling with her gender identity and body changes (Truglio-Londrigan & Lewenson, 2018). The fourth question is whether or not Nancy has had sex with someone. The concept of sex would imply anal, oral or virginal sex. If she has had sex and is sexually active, then it is important to know how many partners she has had, the number of partners in the past year, the gender of the partners, and the types of sex involved, whether protection was used during the sexual encounters. Also, there is a need to know of the past sexual encounters involved incest, rape, statutory rape, or coercion (Pérez, M., & Luquis, 2014).LGBTQ as an Emerging Population

Given that Nancy identifies as LGBT, there is a need to ask additional question. Firstly, there is a need to know if she has a trusted adult to talk to about her sexual orientation and preferences. Secondly, there is a need to assess her safety at home and outside the home, and whether she is being harassed or bullied because she identifies as LGBT. Thirdly, there is a need to determine if she has a link to organizations and communities for support and education. Finally, there is a need to determine past history of STIs (Singer, Mukerjee & Wesp, 2020).

  1. What should be your approach in gathering more information from Nancy?

There is a need to adopt a structured approach in gathering more information from Nancy with well-defined steps. The first step is to explain to Susan (Nancy’s mother) that the interview would be conducted without her being in the same room. This is important for assuring Nancy of confidentiality and privacy. In addition, it would enable her to honestly open up about the details of her life. Once Susan has left the room, the second step is to put Nancy at ease. Confidentiality is ensured at this step, except if Nancy reports being abused or intent to inflict harm in which case mandatory reporting comes into play. This step ensures conformity with the laws that affect patient confidentiality and minor consent (Alexander et al., 2017). The third step is incorporate essential sexual health questions into the broader psychosocial history. This includes answering question from Nancy about her body and/or sex, and asking how the body changes have affected her life. Also, it asks questions about sexual orientation and relationships, as well as sexual activity in terms of type of sex and number of partners. Part of the third step is ensuring that the questions start with the less sensitive topics, such as school, before progressing to the more threatening topics, such as sexuality and drugs. Additionally, there is a need to use open-ended questions, instead of closed-ended question, in order to better facilitate the conversation and help with collecting information that would otherwise be overlooked. Furthermore, there is a need to listen for positive behaviors and strengths, and for the opportunities to give praise where it is due. This is intended to further ease the conversation and collect more information as the patient would respond better to praise and positive sentiments (Singer, Mukerjee & Wesp, 2020).LGBTQ as an Emerging Population

  1. What health issues might you see in LGBT adolescents? What are her risks for contracting an STI?

LGBT adolescents experience health disparities with higher risk of certain conditions, less health care access, and worse health outcomes. The health disparities are because of fear due to institutional bias, discrimination and stigma, limited role models, restrictive health benefits, lack of research on their health issues, lack of specific training and education of health care personnel, and minority status of LGBT persons. The health issues that LGBT adolescents are likely to face could be divided into two groups. The first group is physical health issues with the population being at greater risk of certain infections, diseases and conditions. Given her LGBT status, Nancy is at higher risk of cervical cancer, higher rates of HPV infections, higher rates of breast cancer. The second group is behavioral health with greater risk of substance, tobacco and alcohol abuse, eating disorders, anxiety and mood disorders, and suicidal thoughts and suicide (Montemayor, 2019). LGBT adolescents are likely to engage in high risk sexual behaviors thereby increasing the risk of contracting an STI. Rates of HIV, chlamydia and gonorrhea are twice as high among LGBT adolescents when compared to other populations. This population engages in unsafe sexual behaviors that are influenced by a range of factors to include testing and perception of STIs acquisition, ineffective use of condoms, lack of education on safe sex practices, and earlier age of sexual encounter (Hafeez et al., 2017).

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  1. How should you respond to what Nancy has told you?

Nancy has reported that she is sexually active, has a steady girlfriend and does not like boys, and is not on birth control. As a member of the LGBT community, there is information that would be helpful for Nancy to ensure that she remains healthy. There is a need to guide Nancy towards taking responsibility for herself and others to improve health and wellness, make thoughtful and informed decisions about her health, communicate with teachers, peers and family about issues that affect her health, and provide access to reliable and valid health services, products and information to include HIV and STI testing. In addition, there is a need to argue for the increased use of protection during sex, and having fewer unprotected sexual experiences. Besides that, the response should engage community partners and parents, and make use of health content that is grounded in science, culturally inclusive, developmentally appropriate, and medically accurate (Smalley, B., Warren, J., & Barefoot, 2017). Additionally, the response should describe the risk factors for Nancy as a member of the LGBT community, summary of strategies for reducing STIs, the range of prevention services available, and list of resources that can be access to improve health and wellbeing. Also, there is a need to explore the strategies for preventing STIs, to include vaccinations, nPEP and PrEP as prevention, point of care STI testing, STI screening and treatment, and condoms (Eliason & Chinn, 2017). Adolescent LGBT and STI Research Essay

References

Alexander, L., LaRosa, J., Bader, H., Garfield, S., & Alexander, W. (2017). New Dimensions in Women’s Health (7th ed.). Jones & Bartlett Learning, LLC.

Eliason, M., & Chinn, P. (2017). LGBTQ Cultures: What Health Care Professionals Need to Know About Sexual and Gender Diversity (3rd ed.). Wolters Kluwer Health.

Hafeez, H., Zeshan, M., Tahir, M., Jahan, N., & Naveed, S. (2017). Health Care Disparities Among Lesbian, Gay, Bisexual, and Transgender Youth: A Literature Review. Cureus, 9(4), e1184. https://doi.org/10.7759/cureus.1184

Montemayor, R. (2019). Sexuality in Adolescence and Emerging Adulthood. The Guildford Press.

Pérez, M., & Luquis, R. (2014). Cultural Competence in Health Education and Health Promotion. John Wiley & Sons, Inc.

Singer, R., Mukerjee, R., & Wesp, L. (Eds.) (2020). APN’s Guide to LGBTQ+ Inclusive Health Care: Reshaping Health. Springer Publishing Company.

Smalley, B., Warren, J., & Barefoot, N. (Eds.) (2017). LGBT Health: Meeting the Needs of Gender and Sexual Minorities. Springer Publishing Company.

Truglio-Londrigan, M., & Lewenson, S. (Eds.) (2018). Public Health Nursing: Practicing Population-Based Care (3rd ed.). Jones & Bartlett Learning, LLC. LGBTQ as an Emerging Population