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Introduction

Over the years, an increase in sexually transmitted infection in particular among sex workers within the communities. Sex workers usually stand a high chance of contracting these diseases and this usual impact on their families. The sex workers often fall, victims of the circumstances at work, hence succumb to death (Perspectives on Sexual and Reproductive Health, 2011). They leave behind their families who depend on them helpless. Despite unceasing public campaigns by the public authorities regarding sexually transmitted infections within the society, little changes have occurred (Taub, Birch, Auld, Lysoby, &Rasar King, 2009). Most sex workers argue that they have no option but to live that kind of life despite there being many ways that they can deploy to help them cab such cases. It being their source of income, they have to carry on with it though in a safe manner and by indulging into safe sexual activities. Community nurses have a significant role to play when it comes to promoting sexual literacy within the community. The paper thus focuses on how community nurse can promote sexual literacy in relation to sexual health and decision making among the as well as the sex workers.

Females are often sexually active at an early age at about nine years of age and when they reach puberty stage, most of them are likely to have engaged in sexual activities (Taub et al. 2009). At adolescence, peer pressure contributes much to such activities what puts the lives of these young people at risk. According to the study, most ladies indulge in sex work at an early age following their families status as well as their basic needs not being met. Once they fail to get those basic requirements in life, most of them become sex workers, and this affects their health. Very few of them are safe from the sexually transmitted infections. In most poverty stricken communities, sex workers are very many since its the only means of survival they have. Even though some of the STIs are treatable, some viral infections have no cure and their consequences do last (Perspectives on Sexual and Reproductive Health, 2011). Due to these reasons, promoting health literacy within the community is essential especially to the upcoming generation as well as the already existing sex workers (Taub et al. 2009).

Health literacy according to WHO, refers to cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health (Olea & University of Texas at Dallas,2013). It is relatively a new concept in health promotion. It usually describes many outcomes communication activities as well as health education. With health literacy, the community members stand a chance of learning more about sexual health apart from reading the health leaflets as well as visiting the health providers at health centers. It usually provides improved health information to the clients and even improves their capacity of using that information appropriately. Health literacy also comes with empowerment where the victims gains control over their activities. The individuals are provided with equipment that enables them make healthy decisions, pursue a healthy lifestyle and even change the world in such a way that it suits their way of life(Oshima Lee & Emanuel, 2013). In simple terms, sexual literacy can be described as understanding and evaluation of risks, outcomes, responsibilities as well as impacts of sexual actions. Through it, people gain the ability to integrate their sexuality into their lives, enjoy it, since they know that they have controls over their health (Perspectives on Sexual and Reproductive Health, 2011).

The nurses have a duty to help the community member make informed decisions regarding sexual health as they prevent contraction of STIs (Burns, 2015). They should also ensure that the available resources and services are accessible and also suitable for the community members particularly the sex workers. Health promotion usually enables the people to have increased control over their health life as well as improving it (Olea & University of Texas at Dallas, 2013). It not only focuses on individual behaviors but also moves towards many varieties of social and environmental interventions. It even extends beyond health professionals and includes people like community members, education professionals, families and other groups. For the nurses to promote sexual health among the sex workers within communities, they need several strategies over numerous time frames (Wizemann, Institute of Medicine (U.S.) & Institute of Medicine (U.S.), 2011). For them to succeed in preventing cases of STIs among the sex workers, they have three important strategies that must be in place.

First, they must provide public preventive programs that create awareness and challenge stigma and discrimination against those suffering from STIs (Lippman et al., 2012). By doing this, the victims of these infections will feel free to share with the community nurses about their regarding the health status hence get the necessary help. Second, the health professionals within the community should be trained on particulars skills required when handling sex workers within the communities. Being a sex worker is very traumatizing as others view them as valueless (Centers for Disease Control and Prevention (U.S.), 2011). People usually have minimal respect towards this group of women what makes them fear to come out and speak for themselves. In most communities they are viewed as immoral who deserves no respect from others (Abstracts from the Australasian Sexual Health Conference, 2008).

There are those cultural norms that hinder sex health various communities what usually promote the rapid increase of STI among the community members especially sex workers. Most communities regard sex workers as immoral and valueless. Following the discrimination based on these groups of people, they may find it hard to go for STI test (Hollins & Johns, 2010). Inferiority feelings, as well as misconceptions regarding their behaviors in the community, usually make them isolated from the rest of the people (Abstracts from the Australasian Sexual Health Conference, 2008). These groups, therefore, do face negative sexual health repercussions leading to their unmet needs on reproductive health care and services hence fails to achieve their sexual health rights (Lippman et al., 2012). 

Community Health Services (CHS) are essential in improving clinical outcomes as well as reducing health disparities within local communities. Therefore, a collaboration between communities, patients, and health workers can help CHS in recognizing social determinants that affect sex workers following the sexual health status hence responds to them appropriately (Marmot & Wilkinson, 2005). These services are reinforced by principles of primary health care, health promotion and even use of empowerment in delivering these services. It usually builds a strong bond with local governments, hospitals and all health care to continue within a given community as the local people become self-sufficient (Oshima Lee & Emanuel, 2013). They are significantly relevant to the sex workers within various communities since they encourage their participations and also provide them with both general and targeted services. They can offer them cheap, quality and accessible programs and services and always delivered on time. 

Primary Health Care (PHC) that has been modified into community health care deals with both socially accepted and scientifically proven techniques and technology. Community health care currently uses principles of PHC to meet the needs of their clients. To sex workers, PHC can reduce negative health results like STIs through primary preventions such as using condoms (Abstracts from the Australasian Sexual Health Conference, 2008). By encouraging the sex workers on using protection during sex intercourse, they will be preventing cases of STIs within the communities hence promoting sexual health (Sax, Cohen & Kuritzkes, 2010).

Nurses, therefore, have to develop various strategies and interventions in preventing STIs as a way of promoting sexual health within communities (Shannon, 2010). One of the strategies they will use is seeking to prevent STI. They will first run personal development programs with psychologists, and it will include sexual health issues as well as risk taking actions. In situations whereby some of the sex workers fail to use protections to make much money than others who use condoms. They should be taught the impacts of risking their health for money and how that will affect those relying on their supports (Shannon, 2010). By doing this, the group will be enlightened on the essence of avoiding unprotected sex for the sake of their health as well as those who depend on their support financially.

The second strategy, the nurse should ensure that sex workers receive appropriate services and also provides that information regarding the available local services is accessible.The nurses should always create time meet up with these groups and update them their screening results. Since the people who indulge in sex work are poor, the nurse should offer them free condoms that they can use during sexual intercourse with their customers. They should also provide screening services at a subsidized amount so that most of this people can afford (Abstracts from the Australasian Sexual Health Conference, 2008). By doing so, most of these individuals will be willing have these screenings and also use protection frequently once they know their status.

Conclusion

The nurse should also consider training the group on sexual health. By doing so, sexual health promotion will be done beyond the health centers and clinics. The nurse can communicate with such groups while encouraging them to attend seminars through their leaders. Since they cannot access such groups on their own within communities, they can work together with local authorities as well as their leaders to reach these people (Vancheri, Institute of Medicine (U.S.) & United States, 2010). Their leaders can also be urged to encourage sex workers to attend sexual health sessions for the sake of their health. By employing these strategies, the sex workers will feel free to seek for sexual health advice from community nurses hence make the right decision on how to lead their sex life (Fundukian, 2013). Once they receive training and services from the community health professionals, they can make conclusive decisions on how to handle themselves while carrying out their daily activities in the field.

References

Abstracts from the Australasian Sexual Health Conference 2008. (2008). Sexual Health, 5(4), 381. doi:10.1071/shv5n4abs

Burns, S. (2015). Sexual health, alcohol and the university environment: is there a need for sexual health promotion intervention? Sexual Health. doi:10.1071/sh14215

Centers for Disease Control and Prevention (U.S.). (2011). Bridging the health literacy gap: Health literacy for better public health. Atlanta, Ga.: CDC, Centers for Disease Control and Prevention.

Fundukian, L. J. (2013). The Gale Encyclopedia of Public Health. Detroit: Gale, Cengage Learning.

Lippman, S. A., Chinaglia, M., Donini, A. A., Diaz, J., Reingold, A., & Kerrigan, D. L. (2012). Findings From Encontros. Sexually Transmitted Diseases, 39(3), 209-216. doi:10.1097/olq.0b013e31823b1937

Wizemann, T. M., Institute of Medicine (U.S.)., & Institute of Medicine (U.S.). (2011). Health literacy implications for health care reform: Workshop summary. Washington, D.C: National Academies Press.

Oshima Lee, E., & Emanuel, E. J. (2013). Shared Decision Making to Improve Care and Reduce Costs. New England Journal of Medicine, 368(1), 6-8. doi:10.1056/nejmp1209500

(2011). Perspectives on Sexual and Reproductive Health, 43(3). doi:10.1363/psrh.2011.43.issue-3

Shannon, K. (2010). Violence, Condom Negotiation, and HIV/STI Risk Among Sex Workers. JAMA, 304(5), 573. doi:10.1001/jama.2010.1090

Taub, A., Birch, D. A., Auld, M. E., Lysoby, L., &Rasar King, L. (2009). Strengthening Quality Assurance in Health Education: Recent Milestones and Future Directions. Health Promotion Practice, 10(2), 192-200. doi:10.1177/1524839908329854

Olea, S. T., & University of Texas at Dallas. (2013). Comprehension of medical information in narrative and expository discourse: Implications for health literacy among the Filipino American elderly.

Hernandez, L. M., Landi, S., Institute of Medicine (U.S.)., & Institute of Medicine (U.S.). (2011). Promoting health literacy to encourage prevention and wellness: Workshop summary. Washington, DC: National Academies Press.

Vancheri, C., Institute of Medicine (U.S.)., & United States. (2010). The safe use initiative and health literacy: Workshop summary. Washington, D.C: National Academies Press.

Hollins, S., & Johns, R. (2010). The HIV test. Cape Town: Western Cape Forum for Intellectual Disability.

Sax, P. E., Cohen, C. J., & Kuritzkes, D. R. (2010). HIV essentials. Boston: Pysicians’ Press.

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