Task

Public Health Practice – Unprotected Intercourse And Critical Analysis Of Procedure Needed To Stop Or Minimise Them

Introduce the PH challenge.

Practising sexual activities with no protection is a significant public health challenge. According to an evidence piece, it has been observed that people fall at higher risk of contracting sexually transmitted infections (STIs) and unwanted pregnancies (WHO 2023a). Recent statistical reports have shown that 30% of the world population had sexual intercourse, and 48% did not use any protection the last time they had undergone sexual intercourse (CDC 2023). 8% of the population has been observed to have sexual intercourse by force and without any protection (Leddy et al. 2021).

Moreover, according to World Health Organisation statistics (WHO), sexually transmitted infections transmit more than 30 million bacteria, parasites, and viruses (WHO 2023). Every year, it has been observed that more than 374 million new infections are observed due to unprotected intercourse (Ni et al. 2021). Only 1 out of 4 infections are curable.

Forced sex can cause severe mental health disorders in the human population. The spread of HIV (Human Immunodeficiency Virus) or AIDS (Acquired Immunodeficiency Syndrome) has been observed to be significantly higher due to unprotected sexual intercourse (Yang et al. 2020). Therefore, it can be said that this activity is significantly harmful to the human population as it causes physical health disorders as well as mental problems. 

According to recent statistical pieces of evidence, Thailand has been identified as the highest-rated country to experience unprotected intercourse (Seekaew et al. 2019). Sixty-two per cent of sexual activities were observed to be unprotected, and that concerning new partners. Moreover, Norway, Greece, Sweden and New Zealand have reported 73%, 70%, 66% and 65% of unprotected sexual activities (Qiu et al. 2023). Thus, it can be said that this public health challenge needs to be critically explored by using an analytical framework to check how it makes sense of practice domains such as Health protection (HP), Individual change (IC) and Community development (CD).

The Ottawa Charter framework will be used for the exploration of the above public health challenge as it will help in building a public health policy, create several supportive environments for health practice, strengthen the community action for health against unprotected intercourse, develop personal skills and abilities to avoid these activities and reorient the health services to address the negative impacts of these sexual activities on the human population. Finally, the exploration will help enable, mediate and advocate the practices for the betterment of the human population. 

Primary analysis: Health protection

Health protection is defined as the protection of groups, individuals, or populations via expert advice and effective collaboration for the prevention and mitigation of infectious diseases and environmental, chemical, and radiological threats (van der Vliet et al. 2022). The issue of this assignment is unwanted pregnancies and STIs in the human population due to unprotected sexual activities. 

The health protection criteria are related to the Ottawa Charter (public health theory) (Saadati et al. 2022). The health protection criteria have been observed to be associated with building healthy public policy and strengthening community action for health, including the development of personal skills. This relation has been drawn from the fact that health protection in terms of preventing unprotected sexual activities is associated with building policies of birth control and the usage of protections while undergoing sexual intercourse.

Moreover, communities can also use public health awareness campaigns and programs to educate the general population about the importance of using protections and risks of STIs as well as unwanted pregnancies due to unprotected sex. Finally, health protection can also be associated with increasing self-awareness and the ability to avoid unprotected sex.

However, public health practitioners must be aware of ethical dilemmas concerning the provision of health protection against unprotected intercourses (Chia and Oyeniran 2020). These challenges can include participants not being willing to participate in community health awareness programs, being unwilling to discuss sex, language barriers, and not having enough information about health protection promotion.

Since the population comprises diverse culture-associated people, the language barrier will become a significant ethical issue (Caballero-Hoyos et al. 2022). On the other hand, some people may not be willing to participate in health protection programs due to various personal issues.

Some people might not be ready to receive free protection devices and contraceptives from community health workers in order to protect themselves while undergoing intercourse. They can stigmatise this fact, too.

These ethical dilemmas are associated with health protection in the current scenario. 

According to a case study discussed by Apolot et al. (2020), it can be said that maternal health challenges were experienced by adolescents exposed to unprotected sex in Uganda. The case study has shown that a community service-based intervention was implemented in this nation for the reduction and prevention of unprotected sex.

Sex education, awareness about STIs and birth control-based awareness were observed to be effective for girls to be preventive about unprotected sex. The intervention has successfully worked to reduce maternal pressure and stress of unprotected sex, unwanted pregnancy and prevalence of unprotected sex. 

The main arguments for the fact that the selected way of providing health protection is beneficial for the reduction of unprotected sex prevalence are –

One – Health protection can be provided by implementing policies against unprotected sexual activities.
Two – Health protection will be effective in reducing the thoughts of people in opting for unprotected sex.
Three- Health protection will help in preventing unnecessary births (unwanted pregnancies).
Four – Health protection is suitable for the prevention of STIs from affecting the human population. 

As observed in another piece of evidence, it has been found that governmental regulations associated with unprotected sex were able to control the activity successfully (Coleman et al. 2022). Laws against forced sexual activities were observed to be effective in reducing the prevalence of unprotected sex. Enhancing health protection by using laws, policies, and Education can be stated to be appropriate to solve the issue associated with this discussion. 

Main analysis: Individual change

Individual change (IC) is defined as the efforts an individual makes to bring changes to individual habits and attitudes and finally prevent the occurrence of diseases (Ntoumanis et al. 2021). The diseases mainly include STIs, and the behavioural factors include the urge for unprotected sex. The outcomes also include unwanted pregnancies among women.

Four broad principles have been observed to be associated with IC: personal experience of mastery, vicariously observed mastery, social persuasion associated with encouraging feedback, and physiological feedback based on positive emotions. These principles have been observed to guide the effect of IC in the prevention of unprotected sexual activities in the human population. 

IC is also related to the Ottawa Charter framework for public health promotion. One of the principles of the Ottawa Charter framework is developing personal skills and attributes. This principle is directly associated with IC (Wilberg et al. 2021). In other words, it can be stated that individual change is based on changing the attitudes and behaviours towards a particular activity or phenomenon. The concerned activity is unprotected sexual intercourse, resulting in a high prevalence of STIs and unwanted pregnancies. 

Ethical dilemmas in IC mainly stay with the individual only. Staying honest and transparent with oneself is needed to change behaviours towards unprotected sexual activities. Autonomy has been observed to be an ethical factor which affects IC. This is because of the fact that it deals with the ability of an individual to act based on moral objectives rather than under any influence. So, ethical dilemmas may come into play if the individual associated with IC is under any external influence to carry out unprotected sex. 

Mthembu and Rademeyer (2019) have stated that university students were more prone to unprotected sex. The case study has reported that individual behaviours mattered in their choices to opt for unprotected sexual intercourse. Moreover, it has been observed that university students had negative attitudes toward condoms.

However, ethical dilemmas came to play a major role, and the intervention of IC was not very effective in the prevention or reduction of the prevalence of unprotected sex. The case study-associated students have reported that they were aware of the risks; however, they will not change their behaviour. Thus, personal values and external influences played a major role in shaping the attitudes of individual university students towards unprotected sex. Thus, it can be stated that IC intervention was not effective in reducing the prevalence of unprotected sex delivered by the university stakeholders. The intervention did not work for this scenario. 

After getting information from the case study, it can be said that IC intervention is not suitable for solving the issue. This is because of the fact that IC intervention is only effective when the individuals are willing to change their behaviours towards the specific activity. There are other pieces of evidence that have stated that IC intervention was not beneficial in changing individual behaviours towards unprotected sexual intercourse (Willage 2020).

Moreover, it was observed that IC interventions are not influenced by external factors, and therefore, change in behaviour and attitudes towards unprotected sexual intercourses depends solely on the specific individual. Depending on all the above-stated evidence pieces, it can be said that IC intervention will not be suitable for solving the issue of unprotected sex and the spread of STIs, as well as unwanted pregnancies. 

Main analysis: Community development

According to the definitions of The United Nations (UN), community development can be stated to be a process in which the members of a community make decisions on a collective basis and generate specific solutions to an existing problem (Shaturaev 2021). The selected public health problem for the current report is unprotected sex and the risks of STIs, as well as unwanted pregnancies. Community development is based on several principles, such as sustainable development, inclusivity, empowerment, social justice, participative democracy, human rights, and equality. 

The community development intervention has been observed to be associated with the Ottawa Charter framework in various aspects. The principles of the Ottawa Charter framework have been observed to be directly associated with the use of community development or CD interventions in the prevention of unprotected sex prevention.

The Ottawa Charter framework is based on frameworks such as the creation of supportive health environments, strengthening community actions for health, and reorienting health services (Wu and Oprescu 2021). These three principles are associated with the usage of community development interventions. This is because communities play a significant role in the development of supportive health environments, strengthening community-based actions, and finally, reorienting health services.

Since the communities comprise a large group of individuals working together, they can launch unprotected sex prevention and use of protection while undergoing intercourse in collaboration with local and national regulatory bodies (Pal 2021). They can also reorient community health services according to the requirements of the community to prevent or reduce the prevalence of unprotected sexual intercourse. Therefore, the community development intervention is strongly associated with the Ottawa Charter framework. 

Ethical dilemmas can mainly be associated when communities from diverse cultures are taken into consideration. In other words, people from different cultures may not specifically participate in community awareness programs due to social stigma (Mahamboro et al. 2020).

On the other hand, the language barrier can prevent the community development intervention stakeholders from properly interacting with people from diverse cultures. People may also need help getting proper information about what community development information is about due to the above-stated issues (informed consent). These ethical dilemmas can hinder the community development practice needed to prevent unprotected sex from being practised in the mass population.

The case study of Leddy et al. (2019) has shown that community empowerment is essential for HIV prevention among female sex workers from Tanzania. According to this case study-based qualitative research, it can be said that the community empowerment process was effective in preventing unprotected sex among the workers.

The workers were educated about the prevalence of HIV due to unprotected sex, associated with accessing health and human rights for HIV prevention, care as well as treatment (World Health Organization 2020). Therefore, it can be said that community development practices involve empowerment that is significantly effective in reducing unprotected sex practices in the human population.

The intervention worked successfully, and it was specifically delivered to the sex workers of Tanzania. The high success rate of the community empowerment based intervention was effective in controlling HIV in the selected population and, therefore, is expected to be helpful in neutralising the currently focused issue.

Based on the information available from the previously discussed evidence, it can be stated that community development is well related to the Ottawa Charter framework, and it has been effective in reducing the prevalence of unprotected sex in the human population.

Community development based awareness, empowerment, and Education have been observed to be significantly effective in the prevention of unprotected sex to be carried out in c different communities (Deeks et al., 2020). The main argument concerning the fact that community development is an effective intervention thus stands justified. 

Synthesis

After going through the public health challenge of sexual activities that are unprotected, it has been observed that it leads to the development of STIs and unwanted pregnancies. Three specific domain-based interventions were explored for their effectiveness against the public health issue using the Ottawa Charter Framework.

The strengths of the HP domain have been observed to be associated with the fact that regulations and policies are needed to control unprotected sex. This aligns with governmental regulations, which everyone has to follow. However, ethical dilemmas when communities become resistant to acquiring knowledge about the practice due to stigma and cultural barriers. On the other hand, the strengths of IC interventions are mainly associated with personal skills as well as attitudes.

This was observed to align well with the Ottawa Charter Framework (Milczarski 2019). Therefore, it was thought that IC interventions would be better in reducing the prevalence of unprotected sex. However, weaknesses associated with external influential factors, personal values and choices play a major role in rendering IC ineffective in controlling unprotected sex prevalence.

Finally, CD's strengths have been observed to align completely with the Ottawa Charter Framework. This has been observed to involve the process of building communities which will follow healthy practices to prevent unprotected sex and will further influence other communities. Making collective decisions and reorientating health services according to the needs are two major strengths of this intervention (Wu and Oprescu 2021).

Finally, it was observed that a group of sex workers found this strategy effective in reducing the prevalence of unprotected sex. This intervention had some minor weaknesses where language barriers played a major role. Since this is a joint intervention, an interpreter can be appointed to neutralise the weakness. 

The selected practice domains were observed to be imbalanced in the current public health landscape. Although HP and CD have shown promise, IC has been observed to face significant challenges as represented by the university students. In other words, all the domains were imbalanced. However, keeping all the odds aside, it can be said that CD has some balance to be used as a public health promotion domain in future. 

A more integrated approach has been found to be essential, considering the pros and cons of HP, IC and CDD domains. The domains are needed to neutralise the limitations, especially for the IC domain based intervention. Emphasis on community involvement should be given to reduce the prevalence of unprotected sex in the human population. 

The most suitable practice domain for the current issues is CD since it has fewer limitations, a stronger evidence base and more strength above weaknesses. This has been observed to involve empowerment, Education, and efforts to be demonstrated in specific interventions in several populations (Tarkang et al. 2019). A specific approach is thus needed to combine all three domains – HP, IC and CD, in order to create a greater domain to address the public health issue of unprotected sex.

The features of interventions associated with this modified domain will include community development, implementation policies, and influence the improvement of individual skills and behaviour followed by increasing awareness and Education of communities and taking decisions to act collectively.

Finally, it can be said that the challenges of delivering specific interventions associated with ethics are needed. On a summarising note, it can be said that an appropriate public health practice will involve a more balanced and integrated approach that recognises the weaknesses and strengths of HP, CD, and IC. The CD should be emphasised more in order to reduce the prevalence of unprotected sex and ultimately reduce the prevalence of sexual activities, unwanted pregnancies and STIs. 

Conclusion

On a concluding note, it can be said that the main public health challenge imposed by unprotected sexual activities needs a balanced public health approach to reduce its prevalence. The analytical report has failed to come up with an effective as well as balanced approach to the reduction of unprotected sex in different communities. IC was observed to be highly ineffective.

However, CD interventions were still effective, not considering the minor weaknesses. Since the weaknesses of HP and CD can be deleterious in the long term, the domains have been regarded as needing to be more effective in addressing the issue associated with the current report.

On a summarising note, a modified approach will be needed to address the public health challenge. This modified challenge is expected to neutralise all the limitations of HP, CD and IC domains. However, the section needs extensive research, and this can be done in future studies. Unprotected sexual intercourse can be reduced with maximum support of the individuals engaged in the activity as well as the local and national regulatory bodies. 

Top Healthcare Samples

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