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Rheumatoid arthritis (RA) is an autoimmune-associated pathology with an articular inflammatory basis. RA is diagnosed by severe pain, movement restriction, fatigue, anxiety, depression, and sexual disorder (SD). This pathology can potentially reduce the quality of life and cause many problems. The electronic databases of PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar search engine were systematically searched for the papers reporting the prevalence of SD in patients with RA (by August 2023). Following paper collection and data extraction, the Random Effects model was used to perform the data analysis (CMA, v.2). The heterogeneity of studies was assessed using I2 index. Following the assessment of 53 eligible studies with a sample size of 9,174 cases, the overall prevalence of SD in RA patients was 32.4% (95% CI:24.4–41.6). Also, the prevalence of SD in RA females and males was 36.5% (95% CI: 26.4–48) and 23.5% (95% CI:12.6–39.4), respectively. Based on the findings, the prevalence of SD among RA individuals was found relatively high; thus, the application of measures seems necessary to prevent sexual disorders in RA cases. These strategies are useful for health policymakers. [ABSTRACT FROM AUTHOR]

This paper draws on a qualitative case study of the motherhood experiences of visually impaired Chinese women. The aim is to explain how disability and gender intersected in terms of motherhood experiences. By applying an intersectionality analytical framework, the present study argues that as people with disabilities, visually impaired women encounter more barriers and receive excessive support that threatens their expression of agency throughout motherhood decisions and childcare; as women with disabilities, visually impaired women receive less support from their family of origins compared to men with disabilities. By reinterpreting disability, employing various strategies to resist societal stigmas, and emphasizing their roles in the public sphere, women with visual impairments challenge the boundaries between disability and ability and reframe their relations with the world as mothers. [ABSTRACT FROM AUTHOR]

Barriers and facilitators affecting the social activities of people with congenital physical and communication disabilities are well documented. However, little is known of their experiences of developing sexual and intimate relationships. This study conducted a systematic review of the literature to address this gap in knowledge. Ten online databases were searched for relevant papers between 1990 and 2014. In addition, hand searches of Augmentative and Alternative Communication Journal and the Sexuality and Disability Journal were conducted. Fifteen papers were identified and appraised. The thematic coding approach identified six principal themes. However, the content analysis revealed that the majority of the literature focused on the social needs of people with physical and communication disabilities. Despite evidence that people with disabilities are sexually active, there is little focus on the experiences of people with disabilities developing intimacy and expressing sexuality. The few references to sexuality in the relevant literature focused on protection from abuse, though some researchers called for improved counseling on sexuality and relationships, and improved access to sexual health services. Further research is required to focus on practical and theoretical outcomes to enhance social relationships and sexuality, and offer lovers who use AAC real advice in their search for intimacy. [ABSTRACT FROM AUTHOR]

Comprehensive sexuality education is seen as a key intervention to address the high HIV-incidence rate and low knowledge among young people in South Africa, yet this lacks inclusion of learners with disabilities. At the same time, educators of learners with disabilities experience cultural barriers and lack skills and knowledge on how to deliver sexuality education in accessible formats. In response, the Breaking the Silence approach, a curriculum implementation and disability-accommodating approach, was developed and tested. This paper presents findings from a formative evaluation using in-depth interviews with educators from eight “schools for learners with special educational needs”. The paper focuses on their experience with implementing the approach. The analysis used conventional content analysis and NVIVO software. Educators conceptualized sexuality education within a risk-protection discourse. They revealed that the training and tools enabled them to provide sexuality education in accessible formats, tackle difficult topics such as sexual orientation and masturbation, and improved awareness and assertiveness within their learners. Educators identified the need for further development including a whole school approach, adjustments to differentiating developmental stages and addressing gender-specific topics. Through its application within the South African mainstream Life Orientation curriculum, this approach lends itself for further development and testing through implementing the approach within a whole school setting and ongoing support that will not only drive change in educators’ skills and knowledge but also drive the needed shift in cultural norms and values. [ABSTRACT FROM AUTHOR]

Adolescents and youth with disabilities in South Africa still lack access to sexual and reproductive health and rights services including comprehensive sexuality education, which may increase their vulnerability to SRHR issues such as HIV and sexual violence. This is exacerbated for learners with intellectual disabilities whose educators often lack skills and tools to accommodate these learners in comprehensive sexuality education lessons. The following paper outlines the findings of a formative evaluation of an innovative sexuality training approach for educators of learners with diverse disabilities (Breaking the Silence approach). This approach was developed and piloted with educators across eight schools for learners with intellectual disabilities in KwaZulu-Natal, South Africa. The paper discusses the educators’ understanding and experiences of using this approach. The findings revealed that although educators were able to implement parts of the approach, contextual factors impacted the degree of implementation. These factors were related to perceptions of socio-cultural norms, interpersonal engagement with peers and management, the structural environment of school settings, and the wider community setting. Educators began to address cultural taboos related to talking about sexuality, but were challenged by untrained staff and the larger socio-cultural context, which includes a heighted risk of sexual violence against their learners. The paper concludes with recommendations for a further investigation of the approach within a whole school setting considering the needs of educators to not only acquire skills and knowledge but also to address their larger socio-cultural context in which they have to implement comprehensive sexuality education. [ABSTRACT FROM AUTHOR]

This paper explores choice of marriage partners among individuals with visual impairment in India. The importance of marriage and the desirability of characteristics and traits in the prospective marriage partners were investigated from 42 individuals with visual impairment in the age group of 18-35 years, in Mumbai, India. Non-probabilistic sampling was used to collect data using an online pre-coded questionnaire, where 35 characteristics of the prospective partner were rated on a 4-point scale, along with ranking 16 traits in order of preference. Descriptive and inferential statistics were used for analysis of data. Marriage was considered important for the sample. Family's opinions were considered vital in marital decisions, but individual choice was important. Women preferred older partners as compared to men. More women, than men, considered visual impairment of partners an irrelevant determinant for partner selection. Statistically significant gender differences were found in the valuation of characteristics and traits with women valuing good financial prospects, chastity, good behavior towards parents, desire for home and children, and being teetotal, more than men. Men desired a physically attractive partner whereas women valued financial stability. Women valued the traits of easy going, good housekeeper and good earning capacity while men preferred a physically able spouse. There is potential for research on gendered marriage choices, specifically among various marginalized populations. Interaction of cultural practices and marriage preferences of individuals with disability could be further explored. [ABSTRACT FROM AUTHOR]

Literature shows that learners with disabilities lack access to sexuality education in Africa and are therefore at increased risk of sexual abuse and exploitation as well as exposure to HIV. Teachers in special schools struggle to provide sexuality education to learners with disabilities. However, the challenges and how they are shaped by the teachers' knowledge, attitudes and practice in regards to the subject are little understood. This paper reports on the process of developing, culturally validating and piloting a questionnaire that assesses the teachers' knowledge, attitude and teaching practices. The questionnaire validation used the cultural equivalence testing framework from Stevelink and van Brakel testing for conceptual, item, semantic, operational and measurement equivalence using expert advice, literature, a sensitivity questionnaire and focus group discussions. The validation process provided crucial pointers toward improving and culturally adjusting scales. This has developed a robust tool with the exception of the knowledge scales. In the further process the latter will be refined and adjusted. This tool helps to identify teachers' challenges around sexuality education and has informed the development of a curriculum innovation and toolkit that supports teachers to effectively deliver sexuality education to learners with disabilities. [ABSTRACT FROM AUTHOR]

This paper discusses the knowledge of sexual and reproductive health among people with physical disabilities in Vietnam. A qualitative research design was adopted. Indepth interviewing and photo elicitation methods were used to collect stories from 20 participants. The findings suggest that without formal education about sexual and reproductive health people with physical disabilities in Vietnam gain knowledge through their experiences and from informal sources of information. Participants perceived safe sex to include contraceptive methods, prevention of sexually transmitted diseases, having orgasm together and finding balance between health and sexual needs. Participants related reproductive health to fertility, restriction of family size, sexually transmitted diseases, and self-care in pregnancy. Reasons for insufficient knowledge included limited education due to: disability and poor family background; limited education on sexual and reproductive health issues; absence of family and community discourse about sexual and reproductive health; and lack of information resources. Participants acknowledged that their knowledge was inadequate. They wanted to know more about sexual and reproductive health but lacked access to the relevant information. Health care providers, researchers, and policymakers in Vietnam should address the gaps in sexual and reproductive health care knowledge among people with disabilities in Vietnam and those that provide care to them. [ABSTRACT FROM AUTHOR]

Sexuality is an important priority for people following spinal cord damage (SCD), due to the impact on sensory and motor function, including paralysis and associated mobility restrictions. Men living with SCD report difficulty in achieving and maintaining erection, impaired capacity for orgasm (with or without ejaculation), and increased likelihood of retrograde ejaculation as significant challenges for sexuality. The implications of these issues for men following non-traumatic SCD (spinal cord dysfunction or SCDys) has not been examined. Drawing on interviews with eight heterosexual men following SCDys, this paper seeks to examine the factors that impact sexual satisfaction. Due to a focus on coitus and the significance of erectile function in this, most participants reported dissatisfaction with their sexuality post-SCD. However, this could be overcome through expanding their sexual repertoires. Through providing information and education about non-coitus focused expressions of sexuality, there is scope for sexual rehabilitation services to significantly increase the quality of life of men after SCDys. [ABSTRACT FROM AUTHOR]

Research regarding people with visual, hearing, or physical disability and their experiences with partnership is sparse. Existing studies show that experiences with partnership and sexual activity occur both less frequently and later in life. Feelings of inferiority, common beauty standards, stigmatization, immobility, and overprotective parenting are cited as reasons for this. This paper analyzes the influence of gender and type of disability on the experiences young adults with visual, hearing, or physical disability have with partnership and sexuality. Eighty-four participants aged 18-25 years, with hearing disability (n = 40), visual disability (n = 18), or physical disability (n = 26) were interviewed face-to-face or by phone. Nine out of ten participants had been in a relationship at least once. Seven out of ten had had experience with sexual intercourse. Female participants had more experience with sexual intercourse than male participants. Men had overall more relationships and experienced their first coitus significantly earlier. Participants with physical disability reported fewer relationships and their first sexual intercourse took place at a later age. The participants with hearing disability had the most relationships and experienced their first sexual intercourse earliest. The results of this study show that the study participants have significant experience with partnership and sexuality. On the other hand, the results indicate that an inclusive school system, the reinforcement of a positive self-perception, and supportive parents and educators are crucial for the development of young adults with impairments and their ability to make independent and confident decisions with regards to partnerships and sexuality. [ABSTRACT FROM AUTHOR]

Obesity is associated with increased risk of a number of physical and psychological problems, including heart disease, depression, and sexual dysfunction. We investigated the relationship between Body Mass Index categories, body image, and sexual function using more detailed assessment of potential weight related sexual problems than previous research. We recruited 251 Chinese participants (124 men) aged 18–57 to fill out an online questionnaire regarding sexual function, general body image, body image related to sexuality, and weight-related physical problems during sexual activity. The created body weight category groups with equal age controlling for its potential confounding effect on the association between obesity and sexual function. Participants' and their partners' height and weight as well as the International Index of Erectile Function-5 (IIEF-5), Checklist for Early Ejaculation Symptoms (CHEES), Female Sexual Function Index (FSFI), Body Image States Scales (BISS), sexual body image questions, and a series of questions regarding weight-related physical problems during sex were used. Obese and overweight men had worse erectile and ejaculatory function than normal weight men whereas in women no association with sexual dysfunction was found. Obese and overweight men and women had worse general and sexual body image than normal weight individuals of their gender. For men, Body Mass Index was associated with erectile and ejaculatory function through sexual body acceptance and sexual body shame. In addition, Body Mass Index was associated with ejaculatory function via body image and physical problems related to exhaustion and fat tissue during the sex. For women, Body Mass Index was associated with female sexual function through body image and sexual body acceptance. Finally, we also found that participants' own Body Mass Index was positively associated with their partners' Body Mass Index. The resulted indicate that obesity and overweight have complex relationships with sexual function that clinicians should be aware of. This study is first to investigate the potential mediation psychological and physical factors on the relationship between obesity and sexual function both for men and women. However, the sample size is limited and the cross-sectional design does not allow causal conclusions. Body Mass Index is associated with individuals' sexual functioning via satisfaction with their own body, body satisfaction specifically related to sexual activity as well as physical problems during sexual activity. [ABSTRACT FROM AUTHOR]

Adolescents with hearing impairments have similar sexual risk exposures as their hearing counterparts, yet their sexual information needs are often ignored. This paper examines the disparities in information about the human immuno-deficiency virus (HIV) infection among hearing and hearing-impaired adolescents in Port Harcourt, Nigeria using a comparative cross-sectional survey design. Results showed that awareness about HIV was significantly lower among hearing-impaired adolescents. Most of them did not even know how HIV was transmitted, while many believed that HIV was transmitted through mosquito bites or by eating together or sharing utensils. Only a few understood that unprotected sex was a major risk factor for HIV transmission. Similarly, most of them did not know how HIV could be prevented. Their HIV risk perception for was equally low as only a third had ever tested for HIV compared to two-thirds of their hearing counterparts. The results of the study suggests that significant differences in HIV information and knowledge exists between hearing and hearing-impaired adolescents in Nigeria. The gap is attributed to lack of sexuality and HIV-specific education for adolescents with disabilities, thus unduly exposing them to avoidable HIV risk. It is therefore crucial for adaptation of disability friendly learning strategies that forms an integral part of the Family Life and HIV and AIDS Education curriculum. Equally important is special training for sign language teachers in order to correctly interpret HIV and AIDS information to adolescents using the sign language grammar, syntaxes and communication concepts. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to analyze whether professionals who work with people with an upper limb deficiency (ULD) received questions about sexuality from their patients and whether they addressed sexuality themselves, and to analyze their knowledge and comfort level, approach and attitudes towards sexuality. An online questionnaire, including questions on self-perceived sexological competence and the Knowledge, Comfort, Approach and Attitudes towards Sexuality Scale (KCAASS) was used to asses these aspects. One out of three professionals had received a question about sexuality from their patients. Nearly one out of five professionals had addressed sexuality themselves. Professionals who received a question about sexuality from patients or addressed this issue themselves had significantly higher scores on self-perceived knowledge about sexuality and on self-perceived conversation skills compared to professionals who did not. The scores on the KCAASS Knowledge and Comfort of professionals who received a question about sexuality or addressed the issue of sexuality were significantly higher than those of professionals who did not. Sexuality is thus only scantly discussed by professionals working with patients with an ULD. Professionals indicated they do not feel confident nor comfortable enough to address this issue. They also experience a lack of appropriate knowledge to address sexuality with patients. Professionals reported a need for courses and training on both knowledge and conversation skills concerning sexuality. In addition, a protocol and necessary facilities need to be provided for the team working with people with an ULD in order to be able to address sexuality systematically. [ABSTRACT FROM AUTHOR]

This study is concerned with evaluating cystic fibrosis (CF) annual review practice. More precisely, we wanted to know if we are utilizing genetic counseling services and identifying poor knowledge of sexual reproductive health at annual review. We conducted short interviews with 21 CF patients at annual review regarding genetic counseling knowledge and perception. Patient responses were documented, analyzed and coded using a simple thematic analysis to précis the content. Immediately post-interview, patients were asked to complete a CF questionnaire comprised of nine questions, testing knowledge of the science of Mendelian genetics, contraceptive needs and fertility. Knowledge was then compared to responses documented at annual review. Emerging themes from interviews included: poor knowledge and a need for more information regarding what genetic counseling involves, a positive perception and experience of genetic counseling for those who had attended, and partner anxiety related to carrier testing. The percentage of patients who reported they were aware of the CF fertility and genetic issues was 95%, however, questionnaire scores ranged from 0 to 9/9 (mean 4.8 SD [2.2]). 57% of patients had received genetic counseling. These patients had a statistically significantly higher score 6.2 (1.5) versus those who had not 2.9 (1.3) p < 0.001. The All Wales Adult CF Centre annual review practice is insufficient to identify patients who may benefit from further education on reproductive health. Traditionally these domains have been granted less significance. However, as life expectancy, quality of life and reproductive assistive techniques improve, ensuring appropriate patient knowledge is of greater importance. [ABSTRACT FROM AUTHOR]

The challenges of providing appropriate reproductive healthcare to women with intellectual disabilities are set within the context of a primary health care system. The rationale for this study was to explore the prescribing practices and attitudes of General Practitioner's (GP) when women with intellectual disabilities come to them for contraception. The data reported in this paper come from a cross-sectional postal questionnaire survey conducted with 162 GPs across two counties in England. The majority of respondents had 10 or fewer women with intellectual disabilities of child bearing age on their caseloads. The most commonly prescribed methods of contraception were the Pill (39.7%) and depot medroxyprogesterone acetate (DMPA), (34.2%). The difficulties faced by GPs in determining 'best interests' are explored, as are the issues related to the women's capacity to consent to sex. [ABSTRACT FROM AUTHOR]

Comprehensive sexuality education (CSE) is instrumental in ensuring that young people have the knowledge and skills to make informed decisions and practice safer sex. Worryingly, CSE is often not available to adolescents and young with disabilities. The Breaking the Silence (BtS) approach to CSE was developed to address this gap and help equip educators to teach CSE to adolescents and young people with disabilities. The TSE-Q was designed to evaluate the effectiveness of the BtS approach and monitor changes in educators' knowledge, skills, attitudes, self-confidence, and preparedness to teach CSE to young people with disabilities. The TSE-Q is aligned with an adapted version of the theory of planned behavior. This is a second validation study of the TSE-Q embedded within a feasibility study for the BtS approach. Fifty educators and support staff from two South African special schools for people with disability participated in a BtS training workshop and completed the TSE-Q before and after the workshop. Additionally, participants were asked to complete an adapted version of Rowe, Oxman, and O'Brien's validity questionnaire probing content validity, face validity, and ease of use. Baseline data from the TSE-Q was evaluated for reliability, while the validity questionnaire and verbal feedback were used to assess validity. Most scales show good reliability, but knowledge-based scales have lower reliability due to their multidimensionality. The TSE-Q shows good face validity, content validity, and ease of use, but should be done on different days to any intervention/training. Overall, the TSE-Q is a robust questionnaire with good content coverage. [ABSTRACT FROM AUTHOR]

Past research, media and pop culture, and the medical field have largely overlooked the sexual lives and stories of disabled adults. This research used a long-response survey methodology to collect the stories of over 300 physically disabled adults regarding the interaction between their disability and sexuality, and their experiences navigating sexual partnerships. Data showed there were a variety of challenges sexually active disabled adults faced, but numerous benefits were also described. Additionally, participants discussed the process of choosing a sexual partner, experiences of rejection and "coming out" as disabled, and the experience of communicating with partners about sexuality. This research sheds light on the nuances of disabled sex and sexuality, contributing to a growing body of literature which highlights the interpersonal and emotional aspects of navigating sex as a disabled person. [ABSTRACT FROM AUTHOR]

When it comes to sexuality education, people with disabilities are often left out of the conversation. Many believe that these people are asexual, sexually inactive, that they do not need sexual education, that they cannot and should not have sexual relations and cannot/should not have love relationships and start a family. The main purpose of the research is to determinate thoughts, attitudes, knowledge and personal experience of the parents of children with disabilities regarding comprehensive sexuality education of their children. The data were collected through a survey of 54 respondents, parents of persons/children with disabilities from different regions in the Republic of N. Macedonia. Data were analyzed using the SPSS program and Chi square and Fisher exact test. From the data, it can be concluded that the majority of parents covered by this research are not familiar with the most appropriate age at which sexual education should begin. Around 57% of parents completely agreed with the statement that sex education should be part of the educational program in schools and only 38.9% of parents believe that their child should study all subjects. Children with disabilities need developmentally appropriate sex education to stay safe and healthy and to achieve self-determination. [ABSTRACT FROM AUTHOR]

Experiences of people with disabilities regarding dating applications and websites is sparsely addressed in the literature. Objectives of this scoping review were to ascertain the factors influencing the experiences of people with disabilities in relation to their use of dating apps and websites, as well as to identify solutions to improve their participation in online dating. All references in French or English published since 1993, reporting the experience of at least one person with a disability or a potential partner concerning the use of dating applications and websites to develop intimate relationships were included. Selection and extraction were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis- Extension for Scoping Reviews criteria by two independent reviewers. Data were analyzed by coding according to the main categories of the International Classification of Functioning. Fifteen peer-reviewed studies and 51 Gy literature references were selected from a search of Medline, Embase, PsycInfo, CINAHL and Google. Thematic analysis revealed important themes, such as the Person Beyond Disability, Elicited Emotions, Self-Stigmatization, Safety Concerns with Online Dating, Potential Partner's Perception, Online Environment, Type of Applications and Websites, Compatibility Between Applications or Websites and Adaptive technology, Initiating Contact: for better or for worse, Using Applications and Websites Safely, Dating Online versus In-Person, Disclosing the Disability. Themes could be facilitators and barriers to online dating. Disclosure of disability is at the heart of the experiences reported. Possible solutions to improve social participation included education, improvements for applications and websites, and enhancing accessibility and security. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the sex education needs of people with spina bifida through their responses to a questionnaire. The questionnaire was disseminated to people with spina bifida between the ages of 18 and 40 years. Of the 436 questionnaires distributed, we received 48 valid responses (11.0%). The questionnaire included items related to demographic characteristics and preferences regarding the content of sex education. Twenty-two options were created to ascertain the desired content of sex education. These items were classified into the eight key concepts (KCs) specified by the International Technical Guidelines for Sexuality Education. T-tests were conducted for the eight KCs and gender, age, diagnosis, presence of hydrocephalus, physical function, and dating experience. Overall, most participants wanted to be educated on "KC1 Relationships" and "KC4 Violence and Staying Safe." Participants under 30 years of age wanted to be educated on "KC6 The Human Body and Development." Participants diagnosed with spina bifida aperta and those who used diapers/pads preferred to be educated on "KC2 Values, Rights, Culture, and Sexuality" and "KC3 Understanding Gender." Those who had been in a relationship preferred education in "KC3 Understanding Gender," "KC5 Skills for Health and Well-being," and "KC8 Sexual and Reproductive Health." Considering these results, we should enhance sex education for people with spina bifida. [ABSTRACT FROM AUTHOR]

Objective: Access to trauma-informed sexual and reproductive health services (SRHS) among persons with mental illness (MI) is inadequate and may contribute to health disparities among this population. This qualitative study investigated health professionals' perspectives of SRHS delivery to patients receiving care at a behavioral health hospital. Methods: Semi-structured interviews were conducted in a convenience sample of 26 mental health professionals recruited from one behavioral health hospital. Interviews assessed participants' perceptions of current SRHS offerings, barriers, and opportunities to implement patient-centered SRHS at the hospital. A constant comparison thematic analysis was employed. Results: Participants noted patients' overlapping sexual and reproductive health (SRH) and mental health needs. Most participants indicated clinical responsibility to address these needs. However, participants stated they infrequently provided SRHS because of structural barriers within the healthcare system. Barriers included a lack of hospital policy and health professional education on SRH. Some participants who navigated around these barriers reported using an existing SRH screening tool. Conclusions: Patients receiving care at this behavioral health hospital have unmet SRHS needs. This lack of care may undermine the health of patients with MI. Addressing system level gaps requires clinical re-prioritization. Promising approaches to address this gap include reverse-integrated care models and improved SRHS training of health professionals. [ABSTRACT FROM AUTHOR]

Sexual problems are common after chronic illnesses and disability, yet research indicates that this is a neglected area in healthcare services. Evaluation studies provide evidence of the effectiveness of education in enhancing professionals' knowledge, skills, and comfort in addressing patients' sexual concerns. However, there are limited evaluations aimed at improving ability to discuss sexuality when working with people with disabilities. The overall aim of this study was to evaluate a ' Sexual Respect' DVD as an intervention to improve competence in addressing ' sexuality and disability'. A mixed methods design was used with both quantitative and qualitative components. Nursing students' self-report ratings of knowledge, confidence, comfort and willingness (to discuss sexuality) levels were collected across four time points: baseline, pre-intervention, post-intervention, and follow-up. Data were analysed using one-way repeated measures ANOVAs with post hoc comparisons. Open-ended qualitative comments relating to the barriers and facilitators to discussing sexuality were analysed using content analysis and subsequent frequency analysis. Reported barriers included lack of knowledge about sexuality and disability issues, the patient's level of disability, and waiting for the patient to raise sexuality issues first. Facilitators included education/training, written information, and if the patient raised it first. Overall, the DVD intervention had a significant and positive impact on nursing students' self-reported knowledge, confidence, comfort and willingness levels. The findings are discussed in relation to the PLISSIT model, which emphasises the importance of a proactive approach to addressing sexuality issues. [ABSTRACT FROM AUTHOR]

The study utilized an interview format to examine the difficulties experienced by mothers of children with cerebral palsy. Interviews were conducted in the province of Zonguldak between December 2013 and February 2014, Turkey, at a special rehabilitation center with 15 children with cerebral palsy and their mothers registered at the center. A voice recorder was used during the interviews, but since the mothers expressed their unwillingness to have their voices recorded during the interviews when they talked about their sexual lives, face to face interviews were held in a suitable physical environment without the use of a recorder. A semi-structured questionnaire was used during the interviews. The couples are troubled with many difficulties that include personal relations, social and economic problems, as well as issues involving the sick child's care and education. Many difficulties that include personal relations, social and economic problems, as well as issues involving the sick child's care and education, trouble couples with children diagnosed with cerebral palsy. In connection with these difficulties, it was also seen that the situation took a toll on the sexual lives of parents. In the light of these findings, our recommendation is that rehabilitation centers catering to the education of children with cerebral palsy should have qualified nurses on hand to provide a professional approach to reviewing the difficulties mothers face and emphasizing the importance of sexuality. [ABSTRACT FROM AUTHOR]

This descriptive study was carried out in order to determine the knowledge levels and attitudes of doctors and nurses regarding children's sexual development and sex education. The study was conducted with doctors and nurses who work at various clinics of two state hospitals located in the province of Istanbul. The data collection tool consisted of 58 questions. The Statistical Program for the Social Sciences, version 18.0 (SPSS 18.0) was used for data analysis. It was determined that females comprised the majority of the respondents (61 %) and were over 36 years of age (54.1 %) (37.81 ± 8.82). Of the participants in the study, 63.5 % had bachelor's degrees and 62.1 % were medical doctors. It was determined that the number of correct responses given by the respondents regarding some behaviors observed in children aged between 3 and 6 years and children's sexual development and sex education showed significant differences according to age group ( p = 0.007), marital status ( p = 0.004), the status of having children ( p = 0.004), educational status ( p = 0.005) and occupation ( p = 0.000). However, in a review of the study findings, it was observed that culture had an important impact on sex-related approaches and that embarrassment and shyness is very common. [ABSTRACT FROM AUTHOR]

This study was conducted in order to determine the prevalence of sexual dysfunction and factors affecting sexual dysfunction (SD) in male patients with diabetes. Diabetes is a public health problem. Erectile dysfunction (ED) is seen in nearly half of all males who have had diabetes for more than 10 years. Erectile dysfunction, metabolic and psychological factors are involved in the emergence. A descriptive was conducted and questionnaire was used in this study. Data was gathered via general knowledge form which consists of socio-demographic characteristics and risk factors, International Index of Erectile Function, Quality of Life Scale (SF-36), Beck Depression Inventory, Coopersmith Self-Esteem Scale, and Body Image Scale. SD was determined in 48 % of our cases. The most affected domain among the cases was erectile function (33.1 %) and intercourse satisfaction (29.1 %), and the least affected domain was sexual desire (6.3 %). Most of the male cases with ED had mild and moderate ED (42.6 %). Factors affecting SD's included age, education level, obesity, hypertension, retinopathy, vasculopathy, nephropathy, diabetic foot, HBA1C and LDL levels, diabetes duration, drugs used. All quality of life subgroups scores were lower in male patients with SD than patients without SD except for pain. Depression and body image scores were lower in male patients with SD. SD's are affected by both metabolic and psychosocial factors. Sexual dysfunction in men with diabetes should be routinely evaluated. [ABSTRACT FROM AUTHOR]

Literature argues that people with disabilities have heightened risk of exposure to sexually transmitted infections, including HIV due to lack of HIV knowledge, access to health services, and increased risk of sexual abuse and poverty. People with disabilities lack access to sexuality education. Teachers should be at the forefront to address this; however there is little understanding of the knowledge, attitudes, practices and needs of teachers of learners with disabilities in regards to sexuality/HIV education in Africa. A pilot study was conducted in ten special schools (eight urban, two rural) representing four types of disabilities in South Africa. Data was collected from 99 teachers using scales investigating beliefs and practice in teaching sexuality education, perceived subjective norms, self-efficacy, and materials/professional preparation. Frequencies, means, standard deviations and Cronbach's alphas were calculated for all scales. The data shows that overall teachers have positive attitudes towards teaching all elements of comprehensive sexuality education. However, they find it easier to discuss 'soft topics' around relationships and personal skills (e.g., hygiene) than to talk about sexual behavior and functions. Teachers expressed confidence in their ability to teach sexuality education but indicated that their professional preparation and materials are not adequate to provide accessible sexuality education to their learners. The study highlights the need to develop appropriate materials and to build teachers' capacity to deliver sexuality and HIV education to learners with disabilities. [ABSTRACT FROM AUTHOR]

The aim of this study was to develop an illustrated sexual-abuse prevention knowledge scale and to examine the knowledge of female high school students (tenth- to twelfth-graders) with intellectual disabilities studying at special education schools in Taiwan. An illustrated scale with 20 true/false items and 10 multiple-choice items was developed to assess the participants' relevant knowledge. Each item consisted of a written question and corresponding illustration(s). A total of 196 female high school students in Taiwan participated in the study. Factor analysis generated five factors: puberty physiology, body boundaries, identification of improper sexual relationships, identification of abusive situations, and coping methods when facing abusive situations. These five factors explained 61.71 and 70.70 % of the variance for the true/false and multiple-choice items, respectively. The reliability analysis of the scale showed a value of .81 for true/false items, .74 for multiple-choice items, and .84 for the whole scale. The participants demonstrated a relatively better level of knowledge of puberty physiology, body boundaries, and identification of improper sexual relationships compared to knowledge of coping methods when facing abusive situations and identification of abusive situations. [ABSTRACT FROM AUTHOR]

The aim of this study is to examine sexual dysfunction (SD) and depression in Turkish women with type 2 diabetes mellitus (DM). Forty-five women were included in the sampling. The study inclusion criteria were: literate, 18 years or older, able to speak, understand and communicate verbally in Turkish, not pregnant, having active sexual life, agreed to participate in the study. Patients had been diagnosed with DM at least 6 months before conducting the study. The instrument included questions about demographic variables. In addition, Female Sexual Function Index (FSFI) and Beck Depression Inventory were used. It was determined that the women between the ages 22 and over 50, primary school graduates, unemployed and those living in large family, those suffering from diabetes for more than 10 years were more SD and had higher level of depression than the other groups. A significant positive correlation was found between SD and depression. It was also found that as the level of depression of the patients increased, the mean subtotal and total FSFI scores decreased. [ABSTRACT FROM AUTHOR]

Sexual problems (SP) are often experienced by people with multiple sclerosis (MS) and severely affect their quality of life. The aim of this study is to investigate the relationship between sexual problems and quality of life subscales. 132 women with MS from Iranian MS Society completed demographic and medical history questionnaire. Quality of life was measured by Multiple Sclerosis Quality of Life-54 (MSQoL-54) and sexual problems were quantified by MSISQ-19 which includes items for primary, secondary and tertiary causes of sexual problems. The data was analyzed by using SPSS-18 and Pearson's correlation coefficients were used to examine relationships between sexual problems and quality of life subscales. Statistically significant correlation was found between sexual problems and quality of life subscales. Physical and mental components of MSQoL-54 were strongly correlated with secondary level of SP ( p < 0.001, r = 0.702 and p < 0.001, r = 0.470 respectively). Of primary SP items decreased libido showed highly significant correlation with physical and mental components of MSQoL-54 ( p < 0.001, r = 0.629 and p < 0.001, r = 0.499 respectively). Sexual problems such as decreased libido are highly correlated with quality of life in women with MS. Secondary SP had most correlations with quality of life subscales. Evaluation and appropriate management of sexual problems in MS patients can lead to improving their quality of life. [ABSTRACT FROM AUTHOR]

The majority of children treated in pediatric rehabilitation reach adulthood and develop into individuals with needs concerning sexuality and intimate relationships. However, because sexual health is rarely addressed during rehabilitation, some of these youngsters have unmet needs regarding the development of romantic and sexual relationships, and various other problems. This study evaluates the pilot implementation of a group program for youth and young adults with physical disabilities in four rehabilitation centers and two special schools in a 3-month pre-post study. Ten professionals were trained to apply the program. Both professionals and participants filled-out pre-post questionnaires. In addition, participants were interviewed after the program about their experiences. After the training, two rehabilitation centers and one special school succeeded to offer the program, including a total of 14 participants [79 % male, mean age 19.9 (SD = 4.6) years]. The mean attendance rate for the program was 83 % and the sessions were generally positively received. Ten participants filled out the post questionnaire and reported a decrease in having difficulty with discussing sexuality with their (eventual) partner (Cohen’s d = 0.66). There were no changes regarding sexual self-esteem and self-efficacy. Although contact with professionals and peers was considered valuable, the perceived effectiveness was moderate. Participants missed diagnosis-specific information about sexual functioning. Professionals considered the program to be feasible in their setting. Despite some important barriers, the group program is a step forward in offering specialized rehabilitation for youth and young adults with physical disabilities. To measure its impact for participants, a longer follow-up period and more participants are required. [ABSTRACT FROM AUTHOR]

Physical disability is one of the factors influencing the sexual and reproductive health (SRH) of people. Women with a severe disability receive fewer Pap smear tests, regular mammography examinations, and sex education. This study was carried out to identify the SRH needs of women with spinal cord injuries (SCI) in Tehran (Iran) in 2019. This descriptive cross-sectional study was conducted using the SRHNA-SCI validation tool. The study included married Iranian women between the ages of 18 and 55 years, who had SCI. and were registered with the Welfare Organization of Tehran. A total of 78 questionnaires were collected for statistical analysis. The mean age of the participants was 41.73 ± 8.42 years and they were mainly high school graduates with diplomas (35.9%), housewives (85.9%), and patients with thoracic injuries (61.5%). The SRH needs of women with SCI were the need for improving the quality of services (98.87 ± 2.34%), social needs (98.66 ± 3.03%), the need for services of the Welfare Organization (98.04 ± 6.28%), personal needs (98.03 ± 4.59%), sexual needs (96.58 ± 7.66%), and educational needs (96.83 ± 5.32%), respectively. The provision of low-quality SRH services is seemingly the most important preventive factor, while the absence of family and community support is the factor influencing the promotion of the SRH of women with SCI. Therefore, the attainment of this goal is contingent on the cooperation and interaction of different organizations such as the Ministry of Health, the municipality, the insurance organization, the Welfare Organization, and non-governmental organizations. [ABSTRACT FROM AUTHOR]

This study investigated suicidal behavior prevalence and its association with physical and sexual health, and behavior-related factors among female sex workers in South Korea. Using time location sampling, we recruited 1,083 sex workers for an interviewer-administered questionnaire regarding sexual behavior, sociodemographics, and self-rated health (SRH) status. Participants were also tested for sexually transmitted diseases (STDs). We used binary logistic regression analysis to define suicide attempt factors. Around 28 % of sex workers in the sample reported that they had attempted suicide in the past year. Suicide attempts were independently associated with drinking alcohol almost every day, not using condom regularly, STD infection experience, and unfavorable SRH status. Higher suicide attempt likelihood was associated with poor sexual and physical health, but there was no significant association with the number of customers per week. We thus need to revive STD screening programs provided by the government and to support mental health programs. [ABSTRACT FROM AUTHOR]

The study was conducted to identify attitudes towards patients living with HIV/AIDS of nursing students in Turkey. The descriptive study was conducted in the Adana Health School of Çukurova University in Adana, Turkey. The study comprised 311 nursing students. The data were collected via AIDS Attitudes Scale (AAS). The data were evaluated using SPSS software, using percentage, analysis of variance, t test and Kruskal-Wallis test. Total AAS score of the students was found as 48.67 ± 13.77. The mean domain scores of AIDS Attitude Scale were 19.39 ± 5.66 for Contagion Subscale, 13.28 ± 4.41 for Negative Emotions Subscale and 16.00 ± 6.88 for Professional Resistance Subscale. It was determined in this study that negative attitudes exist towards people with HIV/AIDS among nursing students. These findings were interpreted to suggest that further AIDS education among nursing students is necessary. [ABSTRACT FROM AUTHOR]

The primary goal of this study was to shed light on the sexual behaviors and sexual perceptions of people with physical disabilities living in Portugal. As a result, we adopted a mixed methods study, which utilized a descriptive approach to describe participants' sexual behaviors and a qualitative approach to assess their sexual perceptions. This study surveyed 36 people (mean age = 40.25 years, SD = 10.45), of whom 58.3% (n = 21) were male, almost 70% (n = 25) were single, and the vast majority self-identified as heterosexual. 58.3% (n = 21) of participants did not report partaking in any sexual interactions over the previous 6 months, and 27.8% (n = 10) of study participants claimed to have never had sex. Among those who had engaged in sexual activity during the previous six months, kissing, touching, and caressing (38.9%, n = 6), receiving erogenous zone stimulation (33.3%, n = 5) and performing oral sex (33.3%, n = 5) were the most frequently reported activities. Among sexually active participants who reported not having had sex in the previous 6 months (58.3%, n = 21), only 2 (9.5%) mentioned that they did not have sex because of personal attributes, such as not feeling attractive. The remaining 19 (90.5%) systematically reported a lack of opportunity or a lack of a partner to justify not engaging in any sexual activity. Results from the content analysis of 36 participants' responses revealed the following 9 recurring themes regarding sexual perceptions: the definitions of human sexuality, the positive and negative impact of sexuality on emotional well-being, sexual problems, obstacles to sexual expression, sexual expectations, positive coping/resilience and interactions with society. Finally, it is important to highlight this study's contributions to the demands of people with physical disabilities in Portugal to be seen as sexual citizens. [ABSTRACT FROM AUTHOR]

To describe sexual functioning/satisfaction and relational satisfaction of patients with stroke who received sexual counselling during their rehabilitation 1–5 years thereafter. All adult patients with stroke admitted to one Dutch Rehabilitation Centre between January 2010 and January 2014 with at least two consultations with a sexologist were invited to participate in this cross-sectional survey study. Patients were asked to complete a questionnaire on sexual functioning, relational satisfaction (Maudsley Marital Questionnaire, 0–80; low–high dissatisfaction), health-related quality of life (HRQoL) short-form12 (SF-12) mental and physical component scale (MCS and PCS; 0–100, low–high HRQoL) and mood Hospital Anxiety Depression Scale (HADS, 0–21 low–high depression/anxiety). Descriptive statistics were used for sexual functioning/satisfaction and relational satisfaction. Spearmans's correlation analysis (rs) analyzed the relationships between sexual satisfaction, relational satisfaction, PCS, MCS, depression and anxiety. Of 296 eligible patients, 62 (21%) completed the questionnaires. Mean age 55.4 (SD11.0) years, time-since-stroke 3.5 (SD3.6) years, 33 (53%) were male and 18 (29%) were single. Being sexually (very) unsatisfied was reported by 31 (54%) responders, with 63% being male and 44% female. Median MMQ-score relational satisfaction was 12.0 (IQR 4.25–23.25). A moderate correlation was present between sexual and relational satisfaction (rs = 0.35, p = 0.02). In male respondents relational satisfaction was highly correlated with lower levels of anxiety (rs = 0.54, p = 0.01) and depressive symptoms (rs = 0.71, p = 0.00). Patients with stroke who received sexual counselling during their rehabilitation treatment experience high relational satisfaction in the long term after stroke, despite their problems in sexual functioning. [ABSTRACT FROM AUTHOR]

Sexual dysfunction is one of the most common complaints of patients with multiple sclerosis (MS). The study aimed to determine the effect of counseling based on the extended PLISSIT model (Permission, Limited Information, Specific Suggestion, and Intensive Therapy) on sexual dysfunction and the quality of sexual life of married women with MS. This randomized clinical trial was performed on 70 married women with MS aged between 18 and 45 years referring to the MS Association of Tabriz, Iran. The data were collected using a demographic questionnaire, Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), Sexual Quality of Life for a Female, Fatigue Severity Scale, and Beck Depression Inventory-Short Form Items (BDI-13). A neurologist rated the disability level using the Expanded Disability Status Scale. Using randomization, the participants with a score of 4 or 5 in each item of MSISQ-19 were assigned to counseling and the control group, with block sizes of four and six and allocation ratio of 1:1. The intervention group attended a counseling session or more if needed, based on the EX-PLISSIT model. Data were analyzed using SPSS software (Version 25). Independent t test and ANCOVA were used to analyze the data. After intervention, there was a significant difference between the two groups in terms of primary and tertiary sexual dysfunctions [AMD, − 7.84; 95% CI − 14.82 to − 0.86; P = 0.02]. Despite an increased mean score of quality of sexual life in the intervention group after counseling, there was no statistically significant difference between the two groups [AMD, 9.29; 95% CI − 1.46 to 20.04; P = 0.08]. Although counseling based on EX-PLISSIT had a positive effect on decreasing sexual dysfunction, it could not improve the quality of sexual life of women suffering from MS. Applying sexual counseling approaches with a focus on couple counseling is suggested for improving the quality of sexual life. [ABSTRACT FROM AUTHOR]

For women with disabilities in particular, there is a need for information about both contraception and planning for a baby and preventing sexually transmitted infections (STIs). The study purpose was to determine which variables were associated with whether health care providers discussed birth control or planning for a baby and what enrollees can do to prevent STIs among a sample of female Medicaid enrollees with disabilities. A cross-sectional survey design was used in this study of 584 female Medicaid enrollees in a Midwestern state. Independent variables included demographics, community participation, experiences with primary care providers and care coordinators, whether the survey was completed by the enrollee, the level of activities of daily living help needed, and whether or not they could see the same doctors after transition to Medicaid managed care. Outcome variables were whether or not women with disabilities had conversations with their health care providers about preventing STIs and also birth control/planning for a baby. Results indicate that women's likelihood of having conversations about sexual health with their health care provider varied significantly between participants of different age, ethnic, and racial groups, as well as between women with varying levels of independence. Further research should explore why particular groups of female Medicaid enrollees with disabilities are more or less likely to have these conversations with their providers. [ABSTRACT FROM AUTHOR]

We evaluated whether patients who meet the survey criteria for fibromyalgia suffer from a higher rate of sexual dysfunction and sleep disorders compared to those without fibromyalgia. While 54 of the participants were patients diagnosed with fibromyalgia, the remaining 41 made up the healthy control group of the study. The patients were given four different sets of questionnaires: the Pittsburgh Sleep Quality Index (PSQI), Revised Fibromyalgia Impact Questionnaire, Beck Depression Inventory (BDI) and Female Sexual Function Index (FSFI) in order to evaluate sleep function, fibromyalgia disease severity, depression status and sexual function. We found a mean FSFI score of 19.29 ± 3.35 in the women with FMS and 25.88 ± 2.47 in the control group. The participants with FMS suffered from higher depression rates compared to participants in the healthy group. With PSQI score > 5 indicating the presence of a sleep disorder, sleep disorders were detected in 66.6% of women with FMS and 39.3% without FMS. In the Spearman correlation analysis, weak negative correlation was found between the PSQI and FSFI values (r = − 0.213; p = 0.076). In contrast, a positive correlation was detected between the FSFI and RFIQ (r = 0.578; p = < 0.001). Finally, a negative correlation was detected between FSFI and BDI values (r = − 0.509; p < 0.001). Therefore, physicians who investigate the fibromyalgia syndrome in their routine practice to take the negative effects of sexual dysfunction on female patients into consideration. [ABSTRACT FROM AUTHOR]

Individuals with an autism spectrum disorder (ASD) experience varying difficulties, for many this includes romantic relationships. Existing research in this area is mixed and suggests that compared to typically developing (TD) individuals, those with ASD have a similar level of romantic interest, but less relationship success and lower satisfaction with romantic connections. We aimed to explore one of the many pathways to positive relationship experience, and how these may differ for individuals with an ASD. We recruited 459 individuals (232 diagnosed with ASD) internationally, with 64% being female, a result of the internet-based sampling method. Each participant completed an online battery including the Sexual Behaviour Scale—third edition. Compared to TD individuals, those with ASD reported a similar level of interest in relationships, but reported fewer opportunities to meet potential new partners, had shorter relationship duration, and greater concern about their future relationships. Peer social engagement was found to partially mediate the relationship between diagnostic status and relationship difficulties. This was true for both males and females. Additionally, those with ASD reported learning less about sexuality from their peers and experiencing greater anxiety when meeting a potential partner. The current study identifies some factors and pathways that lead to positive relationship functioning among those with ASD. This will be useful for clinician's who support individuals on the autism spectrum, as it will assist those individuals seeking to establish or maintain positive romantic relationships. [ABSTRACT FROM AUTHOR]

Sexual activity is a central component of intimate relationships and has been shown to have numerous benefits for health and wellbeing. Studies have shown that people with disabilities often report less satisfaction with their sex lives, but none have examined the levels of sexual activity in older adults with visual problems. We investigated associations between self-rated eyesight and sexual activity in a population-based sample of older adults. Analyses were conducted using data from 2587 men and 3238 women participating in the English Longitudinal Study of Ageing. Participants provided information on self-rated eyesight in three domains: overall, at distance, and up close (categorised as: excellent/very good/good/fair–poor), sexual activity (any vs. none in the last year), and frequency of sexual intercourse in the last month (not at all, once, 2–3 times, once a week or more) among those who were sexually active. Associations between self-rated eyesight and sexual activity were examined using adjusted logistic regression. Relative to excellent self-rated eyesight, fair–poor eyesight was consistently associated with significantly lower odds of being sexually active in men (overall eyesight OR 0.41, 95% CI 0.26–0.64, p < 0.001) but not in women (overall eyesight OR = 0.99, 95% CI 0.70–1.41, p = 0.959). However, among women who were sexually active, there was some evidence that fair–poor eyesight was associated with lower frequency of sexual intercourse in the last month (e.g. fair–poor eyesight at distance OR = 0.45, 95% CI 0.31–0.66, p < 0.001). No association between self-rated eyesight and frequency of sexual intercourse was observed for men. Identifying ways to help older patients with impaired vision achieve a more active sex life could help to improve the health and wellbeing of this population group. Visual impairment is associated with lower prevalence of any sexual activity in older men, and lower frequency of sexual intercourse in older women. [ABSTRACT FROM AUTHOR]

Erectile dysfunction and stress are among common post-CABG surgery complications. The present study was conducted to assess the effect of modified cardiac rehabilitation on "erectile dysfunction" and "coping with stress". In the present clinical trial study, 126 male patients undergoing CABG surgery were randomly assigned to treatment (63 patients) and control (63 patients) groups. Control group received conventional cardiac rehabilitation program over 26 sessions. Treatment group received modified cardiac rehabilitation program, including Kegel exercise and training on stress coping strategies in the first four sessions of their rehabilitation program. Patients were assessed before and after cardiac rehabilitation program using the International Index of Erectile Dysfunction (IIEF-5) questionnaire and Endler and Parker Coping with Stress Scale. Data were analyzed in SPSS using ANOVA, T, and Chi square tests. Mean erectile function score significantly increased in both treatment and control groups, but the difference in mean scores for improvement in erectile function was greater in treatment group (P < 0.001). Analysis showed no significant difference in mean differences between two groups in all subscales of stress coping. Intragroup analysis showed significant differences in both groups between mean differences before and after intervention in task-oriented styles {treatment group (P < 0.002), control group (P < 0.001)}, and social diversion-oriented. The results showed that conventional and modified cardiac rehabilitation can be effective in improving erectile dysfunction and stress coping in task-oriented and social diversion-oriented styles in the men patients with left ventricular ejection fraction over 30% following CABG surgery. However, modified cardiac rehabilitation has greater benefits for improving erectile dysfunction. [ABSTRACT FROM AUTHOR]

Sexual health is an important area for social work. Social workers' failure to address sexual health issues in social work practice, due to experienced discomfort, may create barriers toward clients, and lead to their decreased health. Investigating social work students' attitudes toward sexual health, and their perceived competence in this area is crucial for developing social work education on sexual health issues. The aim of the present study was to explore Swedish social work students' attitudes and perceived competence and educational needs regarding communicating about sexual health in their future profession. A quantitative study using the Students' Attitudes toward Sexual Health (SA-SH) in a Swedish sample of 242 social work students. The students considered knowledge about sexual health as important for their future profession. The response patterns indicated that students considered themselves uncomfortable and insufficiently prepared to handle issues related to sexual health in their future profession, which may affect how they succeed in addressing the needs of their future clients. The conclusion of this study is that social work students are insufficiently prepared to address issues concerning sexual health in their future profession. Social work programs need to increase sexual health education as well as training in communicating about sexual health issues in order to meet the needs of the clients. [ABSTRACT FROM AUTHOR]

Self-reported sexuality research among people with autism spectrum disorder (ASD) is small but growing. The current study contributes to this field by focusing on the experiences of 18–30 year-old women, with ASD (n = 248) and without (n = 179), predominantly with sexual minority (i.e., non-heterosexual) identities. Multiple aspects of healthy human sexuality, including sexual desire, sexual behavior, sexual satisfaction, and sexual awareness, were explored. In this study, participants with ASD reported less sexual desire, fewer sexual behaviors, and less sexual awareness than those without ASD; however, the two groups reported comparable rates of sexual satisfaction. Next, relations across sexuality-related variables within each group were explored using partial correlational analyses. In both samples, sexual desire, sexual behavior, and sexual awareness were positively correlated, but sexual satisfaction functioned somewhat differently, correlating negatively and weakly with sexual desire and monitoring in both samples. These findings, alongside future research directions and clinical implications, are discussed in relation to the limited previous research on sexuality among women and young adults with ASD. [ABSTRACT FROM AUTHOR]

Physical disabilities such as a spinal cord injury (SCI) may change the sexual functioning of a person. The aim of this study was to estimate the frequency of sexual dysfunction (SD) in a cohort of Pakistani men with SCI and explore the influence of level and completeness of SCI, financial and educational status, and rural versus urban living on SD. Fifty-nine men with SCI (mean age: 32 ± 9 years) participated in the study. They were asked about sexual desire, sexual intercourse before and after SCI, type of penile erection they could achieve, methods they used to attain erection, attainment of orgasm and ejaculation, and the level of satisfaction with their sexual life. The majority (83.1%) possessed sexual desire but only 22% performed sexual intercourse following injury. Most men (81.4%) were able to achieve erection. The commonest type of erection was reflexogenic (n = 42) and masturbation was the preferred method (n = 35). Only 35.6% were successful in reaching orgasm and 13.6% had effective ejaculation. No one could have children following injury. The largest proportion (n = 20) reported somewhat satisfaction with their post-injury sexual life. Statistical analysis showed that men with incomplete lesions were significantly better in terms of sexual intercourse (p = 0.008) and achieving ejaculation (p = 0.001). Men of younger age were significantly better (p = 0.026) in terms of sexual desire. Educational grade, financial status, urban versus rural living, and the level of SCI did not significantly influence sexual desire, sexual intercourse, reaching orgasm, achieving erection or ejaculation, and satisfaction in sexual life. In conclusion, following SCI, most men in our sample possessed sexual desire and attained penile erection, however, less engaged in sexual intercourse, reaching orgasm, successful ejaculation, or becoming fathers. Individuals with an incomplete injury and younger age seemed more sexually active than those with a complete injury and older age. However, the majority were satisfied with their sexual life. [ABSTRACT FROM AUTHOR]

This pilot study aimed to explore if healthcare professional students participating in a 2-week elective course, Sexual Health in Rehabilitation (SHR), led to significant and sustained change in experienced competence and attitudes towards addressing sexual health in their future professions, when measured with the Students’ Attitudes towards Sexual Health-Danish version (SA-SH-D). Comparison-group design, using the SA-SH-D at baseline, after the 2 weeks course and 3 months after completing the course. Participation in the SHR course significantly changed the students’ attitudes; decreasing their fears of offending the patients and increasing their feelings of comfort in communicating about sexual health, and the results sustained during the follow-up period of 3 months. The results of the intervention suggest that a 2-week elective SHR course leads to sustained change healthcare students’ attitudes towards addressing sexual health in their future profession. Sexual health education positively changed the students’ attitudes, decreased their fears of offending the patients and increased their feelings of comfort in communicating about sexual health. The SA-SH-D is a useful tool to measure results of educational interventions aiming to change healthcare students’ attitudes towards addressing sexual health in their future profession. Future research is recommended regarding students’ attitudes towards addressing sexual health with persons living with disabilities. There is also a need to further research the effect of elective versus compulsory sexual health education in healthcare programs, to lessen the risk that healthcare students in their future profession will not be able to give equal care due to variation in competence and attitude. [ABSTRACT FROM AUTHOR]

Empirical research that addresses sexual orientation in people with an intellectual disability (ID) is limited, and very little is known regarding the personal experiences of lesbian and bisexual women with ID. This study set out to answer the question: What are the experiences of lesbian and bisexual women with a mild intellectual disability in the Netherlands? Ten lesbian and bisexual women (average age of 33 years) with a mild intellectual disability took part in our study comprising of semi-structured interviews. Participants reported that they had found it hard to talk to others about sensitive subjects such as their sexuality, and had been left to figure out information regarding their sexual orientation without support or guidance. Our results point to a lack of information, sexual education and role models when it comes to lesbian sex and women with an intellectual disability. Social contact was often limited, and participants experienced difficulties finding a partner. Furthermore, participants often had to cope with mental health problems and had struggled with loneliness, depression and addiction. Last but not least, our participants reported that they had been discriminated against. Coming out (revealing your sexual orientation) is not easy when you have an intellectual disability. To enable women with ID who have lesbian or bisexual feelings to understand and secure their sexual rights in their daily lives is important. Therefore, it is necessary to provide support in the following domains: sexual education and training, social contact and assertiveness. [ABSTRACT FROM AUTHOR]

Sexuality is an inherent attribute of all human beings regardless of their race, religion and the level of physical fitness. The way it is perceived and manifested is determined by a number of biopsychosocial factors. In some people, including persons with cerebral palsy, the factors and their influence are rooted in the psychophysical condition of the human body. The aim of this study was to answer the question about how the levels of sexual esteem and sexual needs differentiate the sexual behaviors of young people with cerebral palsy. The study being presented was conducted with 62 young persons with cerebral palsy (half women and half men), who were selected using purposive sampling. They were aged 15-25 years and were individuals without cognitive difficulties. The research tool used was the Cerebral Palsy Individual's Sexual Behavior Questionnaire developed by the authors. The findings of the study showed that half of the participants engaged in various sexual behaviors from the list that was presented to them. The frequencies of these engagements depended on the levels of their sexual esteem and sexual needs. Persons characterized by high levels of sexual esteem and sexual needs (much fewer than those with the low levels of both characteristics) engaged in sexual behaviors significantly more frequently. The most frequent among them was direct engagement in sexual activity (petting and sexual intercourse; p ≤ .001) and then exposure to sexually explicit magazines or films (p ≤ .05). [ABSTRACT FROM AUTHOR]

Sexual satisfaction and satisfaction with a relationship are important health indicators with regard to a person's well-being and quality of life. These issues become particularly significant in the case of people suffering from chronic diseases, including type 2 diabetes. The aim of this research was to establish the relations between sexual satisfaction, satisfaction with a relationship, and life satisfaction both generally and in more detailed domains in individuals with type 2 diabetes, compared to individuals without this disease. The research also included testing the mediation role of satisfaction with a relationship in the relation between sexual satisfaction and quality of life. The statistical analysis involved data obtained from a group of 151 subjects including 77 with type 2 diabetes. Methods with recognized psychometric properties were used in the research. The results showed that individuals with diabetes are generally less satisfied with their previous and current life, and they are less satisfied with sexuality and passion, when contrasted with individuals not suffering from the disease. In the group of individuals with diabetes, commitment within a relationship mediated the relations between emotional satisfaction and the sense of control and overall satisfaction with current life, including within the psychological, social, and environmental domains. Relationship commitment also mediated the relations between satisfaction with the physical area and satisfaction with the psychological and social domains. [ABSTRACT FROM AUTHOR]

Traumatic brain injury has been linked with higher incidence of sexual problems. As there have been few published reports regarding sexual functioning in men with traumatic brain injury in Latin America, this study sought to compare sexual measures in men with traumatic brain injury with healthy controls. The hypotheses that males with TBI would experience significantly lower indices of sexual functioning compared to unaffected individuals and that increased age and injury severity would predict lower sexual functioning among participants with TBI were tested. Seventy-one Spanish-speaking Colombian men with a history of moderate to severe TBI who were at least 6 months post-injury, and 71 healthy controls participated by completing the Sexual Desire Inventory, International Index of Erectile Function, Index of Premature Ejaculation, Sexual Quality of Life Questionnaire, Index of Sexual Satisfaction. SPSS 22 was used to analyze the results. When compared to matched controls, males with TBI had significantly lower overall and dyadic sexual desire, sexual satisfaction and sexual quality of life. Erectile functioning, ejaculation control, satisfaction with ejaculation control were reported to by lower in the TBI group than in the control group. Almost 44% of participants with TBI had moderate to severe erectile dysfunction, whereas nearly 10% of the control group had the same. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is associated with a range of deficits that may negatively impact sexuality. Few studies have explored how professionals respond to sexuality issues among individuals with TBI. The present study aimed to examine the attitudes and level of training of international health professionals working with individuals with TBI and whether guidelines exist in their work settings related to sexual issues. A survey composed of 53 questions was developed to evaluate attitudes, professional training, and assessment related to sexuality among health professionals working with individuals with TBI. The sample consisted of 324 self-identified health care professionals. During their training, 83% of professionals reported not taking any specific courses, and 61% reported not taking any type of clinical practice related to sexuality issues after TBI. Approximately 70% reported knowing little information about sexuality issues related to TBI and believed it affected the way in which they address the topic with their patients. Professionals believed sexual expression among both cognitively intact (100%) and cognitively impaired (90%) patients was healthy. Sixty-nine percent reported their work setting had no guidelines to determine if an individual with TBI can consent to sexual activity or not. Sixty-six percent of professionals believed that a patient with severe TBI could consent to sexual activities; however 58% believed it is not their responsibility to determine that. Results demonstrated a need for enhanced educational curriculums with specific courses related to sexuality after TBI. Furthermore, institutions should develop guidelines for the assessment of capacity to consent to sexual activity. [ABSTRACT FROM AUTHOR]