Homos+and+Promos;+Health+Promotion+for+Sexual+Minorities

 __Artefact Description__   In this poster, a Caucasian homosexual couple is featured embracing. They look to be young, between the age of 20 and 30.The male on the left is holding a condom in his right hand. He is also sporting a wedding band on his left ring finger, implying that this is a married couple. The man on the right is wearing a cross around his neck, indicating he is Christian. The body language of the poster implies that it is a happy, caring and sexually active relationship. In the top left corner there is a slogan saying, “Rip & Roll” underneath a large picture of a condom. Just underneath this, it says, “A safe sex message from qahc”. This is a poster that was put up at the Queensland University of Technology Kelvin Grove busway stop.  __Public Health Issue__   The public health issue central to this poster is the delivery of appropriate healthcare messages to a diverse range of social and cultural groups. Interestingly, health may not be the first thing that comes to mind when viewing this poster. The politics of homosexual marriage and sexual relations is inherent in this poster. Given that many nations still define homosexuality as a mental disorder, criminal offence or serious perversion (Casey, 2009, p. 294), it is not surprising that this poster was controversial.The focus of this piece will be on the issues related to delivering culturally appropriate safe sex messages to groups that may be defined as ‘other’. Examples taken from the subject of sex education will be used to demonstrate these issues, as sex education can be a primary source of health promotion.

__Literature Review__   The importance of this issue is demonstrated by the fact that discrimination, real or perceived, against homosexuals may lead to diminished psychological and physical wellbeing (Bahns & Branscombe 2011, p. 388), which can lead to subsequent health problems. The act of publicly excluding ‘other’ groups also encourages the justification of discrimination against these groups (Bahns & Branscombe, 2011, p. 388).The World Health Organisation changed their definition of homosexuality from one of mental illness in 1992. Many nations have not followed this example or may have followed the example, but still heavily police the activities of homosexuals. An example of this is China, where homosexuality was taken off the list of mental disorders, but where homosexual activities are still heavily policed (Casey, 2009, p.294). Perhaps this still recent change to the status of homosexuality as a choice rather than a mental health problem is why homosexuality continues to be an issue of heated argument.

 Stigmatization of homosexuals can be heavily influenced by the language used to represent this group. When the tactics of emotive language and labelling of homosexuals negatively is used, treatment of homosexuals by heterosexuals may be disrespectful and rude. Bahns & Branscombe’s study in 2011 used social media to either encourage or denigrate homosexuality through the use of language. They recorded participants’ responses accordingly. The study revealed that if participants were given scenarios where homosexuality was not legitimized, meaning it was denigrated, participants were more likely to send offensive comments than if they were given a scenario where homosexuality was legitimized. This study showed that heterosexuals were less likely to treat homosexuals badly when they were legitimized. This example shows how important it is to include ‘other’ groups in public health campaigns. By not legitimizing ‘other’ groups, healthcare messages such as the one in this poster would not reach a significant portion of the population.

 Sex is a very important issue for young people. The word ‘sex’ is the most searched for word on the internet (Goldman, 2010, p.49). Furthermore, there is a 15 year gap between the average age of commencement of sexual activity and the current average age of marriage (Goldman, 2010, p. 48). In the face of rising numbers of sexually transmitted infections, safe sexual health messages such as the one in this artefact seem to be appropriate, even necessary, from a public health perspective. Human Immunodeficiency Virus (HIV) is projected to increase by 30% in the Australian population in the next ten years (Australian Institute of Health and Welfare, 2011). Cecelia Gore, Director of Education of Family Planning Queensland says, “When sexuality and relationships education is not provided in schools, our young people are at risk of everything from sexual abuse to unwanted pregnancies and sexually transmitted infections,” (Feeney, 2011). This principle may apply to public health promotion messages. Without educational messages aimed to include all types of couples, the result may be poor sexual health. Statistics indicate that infection rates are rising in Australia, going from approximately 14, 100 in 2008 to 19,100 in 2010 in Victoria alone (Department of Health, 2011). Little formal sexual education leads to increased numbers of STI’s, life –threatening illnesses, poor decision making, and accidental pregnancies (Goldman, 2010, p. 47). All of this information confirms the need for culturally appropriate delivery of sexual messages relevant to current social and cultural trends.

 Peppard’s research in 2008 related to a similar uproar in 1985 over a sexual education program introduced in South Australia called SHARE. The uproar was due to concern over the introduction of homosexuality discussions in sexual education. At that time public opinion was used to sustain a fear of homosexuality and ensure the ‘deployment of sexuality’ remained within the heterosexual norm. This author’s research also led to the conclusion that helping to fuel negative public opinion by using derogatory language and tactics based on emotion rather than evidence may actually be a way to advance the political goals of the Christian Right. Meetings that were held about the SHARE program in South Australia involved exaggerations such as the idea that including sexual minorities, such as homosexuals, in the curriculum would encourage homosexual behaviour and threaten “normal” children (Peppard, 2008, p. 507).

 Furthermore, advertisements used emotive language such as ‘stealing your child’s innocence’ (Peppard, 2008, 508). Peppard (2008, p. 504) stated that Christian Rights groups can gain members, funds and community activism through labelling sex education negatively. Moreover, Peppard (2008, 504) argued that opposition by the Christian Right to sexual education in South Australia also allowed for political advancement. The relevance of this study to the issue of delivering sexual health messages lies in the fact that political advancement may sometimes override the delivery of necessary public health campaigns.

__Cultural and Social Analysis__ <span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;"> <span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;"> The importance of delivering appropriate healthcare messages has been highlighted by recent media coverage of the fight for and against having this poster displayed. When this poster was first released, it created uproar among the Australian Christian Lobby. They collaborated to make so many complaints that Adshel temporarily removed the posters from bus stops. Adshel had to then put the posters back up amidst complaints from groups claiming homosexuals had the right to be represented publicly. The question is why? Foucault theorised about the deployment of sexuality. This is a concept that sexuality is largely influenced by social norms rather than being a biological prerequisite. This means that heterosexuality, as it is known in western cultures, may only be standard because socially people say it is and culturally it is reinforced. Political parties may benefit from remaining within this created sexual norm.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;"> Bahns & Branscombe’s study can serve as a way to explain why this artefact was removed and then put back up. Christian Lobbyists may, in essence, have been arguing the illegitimacy of homosexuality and gay rights activists arguing the legitimacy of homosexual rights. Adshel, the company displaying the public health advertisement, was simply acting according to instructions, paralleling the participants of Bahns & Branscomb’s study. Social Identity Theory was used as the basis for the method of investigation, and to help understand the findings. It was theorized that group-based self-esteem was related to identification with the particular social group a person belongs to. However, when separate social groups interact, certain inequalities become obvious. Usually one group will be dominant over the other, in this case heterosexuals over homosexuals. The consequent power structure of the group is dependent on how legitimate the differences in the group are perceived to be: as stated previously, a positive depiction of homosexuality resulted in more positive attitude from study participants.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;"> The argument against allowing this artefact to be displayed parallels the argument for and against sexual education. In western cultures, sex, although undertaken by younger and younger people, still has a kind of taboo around it. Although statistics clearly indicate that sexually transmitted infections are becoming increasingly prevalent in the population, Christian Lobbyists managed to bring the poster down meaning important information may not have been passed onto the intended audience. In effect, the needs of homosexuals are not being met by public health systems. Queensland appears to believe backlash is a bigger problem than the future ill health of their citizens. Although Queensland is not taking a narrow abstinence-only-until-marriage type of policy, which research indicated has little success, in effect the needs of sexually active students are not met. Sex education in Queensland is not mandatory and there are no clear guidelines for what to include should it be provided. Teachers can skip over or ignore the topic altogether. This is what appears to be happening in the case of this poster: out of sight out of mind. Public health experts may need to focus on changing perceptions about homosexuals. This may be in the form of using language that shows homosexuals positively.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;">__Analysis of the Artefact__ <span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;"> <span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;"> This poster represents a group that may be termed as ‘other’ in Australian society, namely, homosexuals. The fact that this artefact received such a widespread and heated response in the Australian media shows that this is a topic of current importance in Australian society, and certainly in public health. Pictured in the artefact are a real Australian couple who make their relationship look completely natural and normal. This added to the validity of the fight to keep this poster up. The artefact and associated research demonstrated firstly the need for culturally relevant delivery of sexual health messages. But equally importantly it demonstrated some of the issues around the difficulties in delivering these messages. The most pertinent example of this is the way that political/religious groups may interfere with public health messages to advance their own political beliefs.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;"> The research encountered during the writing of this essay made the nature of public health in terms of services and messages much clearer. I learnt about the difficulties in the progress of public health versus cultural, political, religious and social concerns. The research showed the complexity of delivering public health messages. Health messages, although aimed to help current health issues in society, are influenced by the aforementioned factors as well as public opinion, which may be based and fuelled on perceptions and emotion rather than reason. In future assessment items, the role of political concerns of different parties will be examined when considering public health issues. In my future health practice, the validity of social stigma surrounding ‘other’ groups such as homosexuals will be considered. Sexual minority groups will not be treated any differently to heterosexuals.

__<span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;">References: __ <span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;"> Australian Institute of Health and Welfare (2011) //Infectious Diseases: sexually transmitted infections in Australia//. Retrieved from: []

<span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;"> Bahns, A. J. & Branscombe, N. R. (2011) Effects of legitimising discrimination against homosexuals on gay bashing. //European Journal of Social Psychology, 41//, 388 - 396

<span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;"> Casey, M. (2009) Addressing key theoretical approaches to gay male sexual identity: issues and insights fort practitioners of mental health. //Critical Public Health, 19//(3-4), 293-305

<span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;"> Department of Health, Victoria, Australia. (2011). //Surveillance of notifiable conditions in Victoria.// Retrieved from: []

<span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;"> Feeney, K. (2011, May 20) Teaching teachers to talk ‘the talk’. //Brisbane Times//. Retrieved from: []

<span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;"> Goldman, J.D.G. (2010) The new sexuality education curriculum for Queensland primary schools//. Sex Education//, //10//(1), 47-66

<span style="font-family: 'Times New Roman',Times,serif; font-size: 140%;"> Peppard, J. (2008). Culture Wars in South Australia: the sex education debates. The Australian journal of social issues(0157-6321), //43// (3), 499 - 516