The Houston Gay Community’s Health Nursing

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Table of Contents

Introduction
Community Health Genogram
Community Assessment
Community Diagnosis
Conclusion
References

Introduction

Houston, Texas Gay community is made up of about 86,000 members, but most of the gay people are located in Montrose area, Harrison County (Rubenstein, 2003, p. 1). Other counties where gay people live (but in smaller populations) include: Kenedy, Loving, Roberts, and Borden Counties. However, apart from Harrison County, which has registered a high number of gay people, there are also other counties such as Dallas, Travis, Tarrant, and Bexar which have registered similar numbers of gay people (Rubenstein, 2003, p. 1). Collectively, these counties represent 44% of the Texas population and more than 58% of the total gay population in the state. The number of gay people in Houston gay community, according to gender criterion, is almost 50%, on both sides, because it is estimated that, there are about 21,740 male couples and 21,172 female gay couples (Rubenstein, 2003, p. 1).

In terms of racial profiling in the Houston gay community, the observations are closely similar to the statistics characterizing the general gay community in America. In the order of the highest ranking racial group, American Indians lead the perk, followed by Asians, Blacks, Hispanics, and white people (Rubenstein, 2003, p. 1). In this gay community, children are normally a characteristic of the gay couples, but the frequency is not as high as in heterosexual relationships. It is estimated that close to 48% of the married gay couples in Houston gay community have children living with them, and about 13% of the gay couples in the state have children living with them (Rubenstein, 2003, p. 1).

In terms of socioeconomic status, the Texas gay community lives in good economic conditions, based on the fact that, their community embraces a higher level of diversity and therefore, poses lower levels of barrier to entry in the job market. Also, from the same diversity, a higher sense of cultural diversity is embraced in this community, and in the same regard, many employers in the region embrace the diversity brought about by gay people (Rubenstein, 2003, p. 1).

Considering the demographics of this population group, this study seeks to carry out a community health analysis of the Houston Texas gay community, with a special emphasis on the health risks and health implications in the community. Emphasis will be made on the sexual behaviors of community members and the subsequent susceptibility of the community to sexually transmitted diseases and AIDS. Finally a community health diagnosis will be made.

Community Health Genogram

From the above genogram, we see that, the Houston Texas Gay community poses unique health challenges. For instance, the level of promiscuity within the gay community is high and this poses unique health challenges because such behaviors increase the health risks of the community to contracting diseases such as HIV and STDs. More so, the level of monogamy among the gay men are extremely low and research studies show that, up to 60% of gay couples have had sexual relationships with other men (out of their unions); while more than 90% are said to have had relationships that lived for less than five years (Diggs, 2002, p. 3). The promiscuity level in this gay community emanates from the fact that, the members live under the impression that, with their sexual orientation, there is a strong sense of brotherhood and sisterhood, which acts as an avenue for partners within such relationships to have multiple sexual partners. The level of sexual promiscuity is however not high for lesbians, as it is for gay males. In terms of physical health, the Houston gay community is predisposed to a higher risk of having physical injuries, based on their sexual activities (some of which are not well understood in the heterosexual world). Clearly, these sexual activities also increase their risk of contracting sexually transmitted diseases. The risks associated with transmitting sexually transmitted diseases are highest for lesbians because of the nature of their sexual activities, and in the same measure, this population group has been affirmed to be at a higher risk of having sex with male partners who are highly prone to AIDS (Diggs, 2002, p. 3).

The mental health status of the members of the Houston gay community is also representative of a high risk sexual group, which is prone to psychiatric illnesses, including suicide attempts, drug abuse, among others. Extreme cases of such mental health conditions have been evidenced in more gay-friendly states such as Netherlands, and this has resulted in severe medical problems (Diggs, 2002, p. 3). Such health risks abound, members of the Houston gay community have a shorter lifespan than the ordinary person, with research studies showing a 20 year difference in lifespan (Diggs, 2002, p. 3).

Community Assessment

Understanding the population distribution of the Houston Gay community is important in the establishment of the geographical regions where health services need to be availed. Areas with a higher population of gay people need the most attention, with regards to healthcare services, because it is at these zones that health services are highly demanded (Diggs, 2002, p. 3). It would be a futile exercise availing gay health services to regions which do not have a strong need for such services. An area like Montrose area, Harrison County is singled out as the zone with the highest concentration of gay people and from this analysis; we can establish that such a region should have sufficient healthcare services to meet the anticipated demand.

Moreover, accessing such a population (to provide them with healthcare services) is easily determined by the location of this population group. Though many organizations carry out extensive research and understand the locality of the gay people, it is important to be sensitive to the small subgroups existent in the gay community because certain divisions such as racial groups often affects the quality of service to be offered to the people (Urban Institute Press, 2011, p. 5). For example, certain racial groups often do not identify themselves as either gay or lesbian. Having a good description of the locality of the gay community is therefore critical in establishing how health workers would access them.

Understanding the sexual patterns and the nature of the sexual activities in the gay community is also important in establishing the kind of treatment or care services that can be offered to such groups. Moreover, such statistics are important in establishing the HIV risk factors and the sexual behaviors of members of the gay community in general. In terms of HIV prevalence, the importance of understanding the locality of the members of the community cannot be underestimated because there are some regions where data related to HIV patients is not sufficiently collected. Many of such locations use AIDS Incidence data to base their health requirements and formulate their health policies, but this is often not the best approach to take, because for example, someone may be affected with the HIV virus for a long time without exhibiting any symptoms manifesting in AIDS (for proper diagnosis to be carried out) (Urban Institute Press, 2011, p. 5). Any data which primarily relies on the prevalence of AIDS may therefore portray a distorted picture of the gay community in question.

The economic statistics of the gay community is important in the provision of healthcare services because through such statistics, the ability of the community to pay for healthcare services can be easily assessed. Moreover, understanding the economic dynamics of the Houston gay community will be important in assessing the viability for various health programs (World Health Organization, 2011, p. 1). This analysis is important because the utilization of minimal healthcare resources is often a core problem experienced by most healthcare administrators. Knowing the economic dynamics of the gay community is therefore important in weighing the costs and values of various healthcare programs and in determining the tradeoffs among various healthcare alternatives, based on the economic incentives in consideration. Moreover, in properly assessing the health and environmental impact of the programs to be undertaken in the community, the economic dynamics need to be considered to come up with good policy considerations (World Health Organization, 2011, p. 1). Assessing the economic viability of the health programs in consideration, viz-a-viz, the economic potential of the community’s members; it is easy to conceptualize the hidden costs and benefits of the policy options to be considered for the community.

Assessing the cultural dynamics of the Houston gay community is also an important tool in the improvement of healthcare services. It is obvious that the provision of good healthcare services is not dependent on one strategy but rather, the sensitivity to the cultural implications of a specific community (AETC National Resource Center, 2011, p. 1). There are therefore certain healthcare practices which may efficiently work on a patient from one cultural group, and yet completely fail with another patient from another cultural group. It is from this understanding that racial profiles of the community members are sufficiently provided because they represent different cultures and consequently, the different cultural dynamics affecting healthcare provision. Considering the Houston Gay community is categorized in several racial groups, with the leading group being American Indians, healthcare services should therefore be sensitive to the unique cultural dynamics of the American Indian community, followed by other racial groups, in that order.

Community Diagnosis

The male gay sexual habits in the Houston gay community is obviously unique and significantly has a special impact on the delivery of healthcare services. For instance, the incidence of sexually transmitted diseases among the gay community in Houston is established in unfamiliar places. As such, a simple sore throat can longer be termed “simple” and in the same manner; a case of hemorrhoids is no longer easily solved through surgical procedure. For a proper diagnosis of the health implications of the male gay community, the sexual history and other similar probes should be done on patients to have a correct picture of the patient’s healthcare needs. Failure to ascertain the above, may lead to a misdiagnosis. The probing of a patient’s sexual history will therefore ascertain the occurrence of new medical cases, such as anal cancer, anal gonorrhea and renal Chlamydia; but these diseases may easily manifest as cases of hemorrhoids and equally be subject to wrong medication (Diggs, 2002, p. 3). In fact, certain statistics depict a situation where incidences of rectal and throat gonorrhea does not show any symptoms, and therefore, chances of a wrong misdiagnosis may occur. In this regard, the importance of understanding the sexual habits of the gay community members are invaluable, and as a result, careful probing should be done by the health practitioners to ascertain the sexual habits of the gay community members. More importantly, resources should be diverted to tackle diseases which affect the gay community in large numbers.

With regards to female members of the gay community, the sexual habits and patterns of the population should be analyzed, and their susceptibility to AIDS and STDs be properly ascertained. Since this study establishes that this group of women is highly bound to have sexual contact with men, their chances of contracting AIDS is higher than the heterosexual female and therefore, they suffer a high risk of contracting bacterial vaginosis, Hepatitis B, and Hepatitis C,(Diggs, 2002, p. 3). In fact, research studies done in Australia have established that, women in this population group is 4.5 times as likely to contract AIDS and STDS more than the heterosexual female because they are highly likely to have sexual contact with high-risk males (Diggs, 2002, p. 3). Moreover, research studies have established that, this population group is highly likely to engage in drug abuse, prostitution, cigarette smoking and such like habits (more than the average heterosexual female). In this regard, new medical complications are likely to be observed from this population group. For example, intravenous drug abuse is likely to be detected in this population group and incidences of bacterial vaginosis are very prevalent and may consequently result in pelvic inflammatory; besides other sexually transmitted diseases (Diggs, 2002, p. 3). Lesbians are also at risk of contracting the numerous sexually transmitted diseases from the homosexual community, when they have sexual contact with the gay males in the community, since they live in the same community as gay men. Even women from the gay community who have had no sexual contact with men are under a high risk of transmitting other sexual diseases. In this regard, Diggs (2002) establishes that:

“Although researchers have only recently begun studying the transmission of STDs among lesbians, diseases such as “crabs,” genital warts, chlamydia and herpes have been reported. Even women who have never had sexual contact with men have been found to have HPV, trichomoniasis and anogenital warts” (p. 4).

Since it is established in this study that the Houston gay community is highly likely to suffer from mental health illnesses, it is important to establish that, health services can be tailored towards changing the community’s perception of gay relationships because research studies ascertain that, mental health illnesses and more so, psychiatric illnesses among gay community members normally start as a result of the stresses involved in community stigmatization of gay relationships (Diggs, 2002, p. 3). Designing healthcare programs to appeal to the sensitization course of gay relationships within the Houston community will therefore go a long way in eliminating the susceptibility of the gay community members to psychiatric illnesses.

Regardless of the community’s contribution to the prevalence of mental health diseases among the gay community, it should be understood that, gay community members are likely to be easily affected by homophobia (especially among the gay youth in the community). Other mental related conditions such as high stress, bipolar disorder, depression, panic disorder, agoraphobia (and the likes), are also likely to be detected in the gay community, especially among first-timer gay youth, who may be living under the pressure of being gay and dealing with the social stigmatization of such groups (Diggs, 2002, p. 3). Females living in the gay community, and especially those who may have just accepted their new sexual orientation, are also likely to be diagnosed with certain mental complications, such as excessive alcohol dependence, social phobia and major depression, because they deal with the social pressures associated with their new status, just as their male counter parts do. Research studies done in the recent past tend to suggest that, the high risk of mental disorder among patients in the gay community may be widespread for adults as well, than previously thought (Diggs, 2002, p. 3). However, this is a new course of study that should be further explored.

The high risk mental health associated with gay members of the Houston community may equally affect the prevalence of risky sexual behaviors among other members of the community, even though some may be aware of the risks involved with such sort of behavior. The increased susceptibility of gay community members to mental health disorders may further worsen this situation, based on the fact that, some may take voluntary risks and predispose themselves to further sexual risks, by having sexual contact with strangers. More so, the high prevalence of drug abuse and alcohol use among such gay members may further increase their susceptibility to more sexually transmitted diseases. There are several incidences reported of gay men who have unprotected sexual contact with other people, based on the fact that, they were depressed, thereby putting other people at risk (Diggs, 2002, p. 3). In such situations, the risk of contracting sexual diseases are very high, but the unfortunate fact is that, even with increased access to healthcare services and education, it may be very difficult to curb such habits because members of the community may deliberately engage in risky sexual behavior. In such situations, the best possible course of action would be availing care treatment for people who may be infected with sexually transmitted diseases because prevention services may not effectively work.

Conclusion

This study identifies that there are significant health implications in the Houston gay community, based on the fact that, they are increasingly exposed to sexually transmitted diseases and Aids because of their risky sexual behavior and patterns. The Houston gay community is identified to be highly susceptible to sexually transmitted diseases and AIDS because they are highly promiscuous and this exposes them to other forms of illnesses such as mental health illnesses and physical injuries. Consequently, this makes them a high-risk group and shortens their life-span. As a result, we can establish that, the Houston gay community requires unique healthcare services, based on their healthcare needs. We can also establish that, preventive healthcare services and health sensitization should stand at the centre of the medical services to be provided to the community because this reduces the prevalence of sexually transmitted diseases, emanating from risky sexual behavior. More so, since this study establishes that, members are under the risk of exposing themselves to sexually transmitted diseases, regardless of their understanding of the healthcare risks (based on their poor mental health status), it is important to note that, more healthcare services should be provided to such sections of the population because preventive care may not be effective. In this regard, it is important to establish that, preventive and care services stand at the centre of the healthcare services to be availed to the Houston gay community.

References

AETC National Resource Center. (2011). The Importance of Culture in Care. Web.

Diggs, J. (2002). The Health Risks of Gay Sex. Web.

Rubenstein, W. (2003). Some Demographic Characteristics Of The Gay Community in The United States. UCLA: UCLA School of Law.

Urban Institute Press. (2011). The Gay & Lesbian Atlas / Chapter One. Web.

World Health Organization. (2011). Economic Assessment. Web.

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