Sexual and Reproductive Health Issues in Persons with Disabilities: A Situational Analysis from the Indian Subcontinent

Background:  Disability is an umbrella term, covering impairments, activity limitations, and participation restrictions. About 80% of disabled persons live in developing countries, and constitute the most stigmatized sections of society with deprived sexual and reproductive health services. Sexual health is fundamental to the physical and emotional well-being of individuals, but sadly, is excluded from outreach efforts, in persons with disabilities. The huge paucity of data in this field, prompted this study, which is a situational analysis of the sexual and reproductive health issues of people with disabilities.

Methods:  A cross-sectional survey was made on people with disabilities, attending various out/in patient facilities of a large tertiary care hospital in New Delhi, India. A structured, pre-tested questionnaire, was used on 100 subjects, to assess their knowledge, attitude and practices  towards sexual and reproductive health issues. Samples were collected from consenting individuals for diagnosis of various STIs, when relevant. Statistical analysis was done to elicit association between various variables.

Results:  Most subjects were 15-30 years, and unmarried (57%). Disabilities included- sensory and motor (52), purely motor (29),  purely sensory (9) and cognitive (10). Among the subjects, 64% were unsure of the sexual impact of their disability, while 9%  affirmed that it did affect their sexual health. Contraceptive usage was 33%, with condoms being the commonest, followed by intra-uterine devices. There was a statistically significant relationship between educational status and use of contraception, knowledge of  HIV prevention and  mode of spread of HIV.

Conclusions:  This is a pioneer study on a grossly neglected issue in India. The major hurdles to quality sexual health identified were in contraceptive usage, negligence by partner following disability and fertility problems. There is a dire need to address the sexual and reproductive health issues of persons with disabilities, to achieve the universal WHO goal of “Health for All.”