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Research examining the effects of spinal cord injury on sexuality has largely focused on physiological functioning and quantification of dysfunction following injury. This paper reports a systematic review of qualitative research that focused on the views and experiences of people with spinal cord injury on sex and relationships. The review addressed the following research question: What are the views and experiences of people with spinal cord injury of sex, sexuality and relationships following injury? Five databases were relevant and employed in the review: CINAHL (1989–2016 only), PsychInfo, PubMed, Scopus and Web of Science, for research published between 1 January 1980 and 30 November 2019. After removing duplicates, 257 records remained and were screened using a two-stage approach to inclusion and quality appraisal. Following screening, 27 met the criteria for inclusion and are reported in the paper. The review includes studies from fifteen countries across five continents. Two main approaches to data analysis summary and thematic synthesis were undertaken to analyze the qualitative data reported in the papers. The analysis revealed four main themes: sexual identity; significant and generalized others, sexual embodiment; and; sexual rehabilitation and education. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities (PID) experience the same range of sexual thoughts, feelings, desires, and activities as anyone else. However, the public's view, especially about stereotypes, is noticeable to have an impact on sexuality and people with disabilities, thereby influencing the population which includes the families of PID, healthcare professionals, and policymakers. This review aims to analyze the opinions of public, family of PID or care staff on the sexuality of PID and the methodology applied. Eleven quantitative peer-reviewed papers were identified. Participants' attitude could be evaluated as a binary classification of either "Restrictive" or "Acceptance" in four aspects. Demographic background and the conditions of the PID were found to have an influence on people's attitudes. People acknowledge that PID are not asexual but generally the public holds a more accepting attitude towards the sexuality of PID when compare with family of PID or care staff. Further research on this attitude gap is particularly essential, as this will contribute valuable information and provide insight to policymakers on handling the social, legal and ethical concerns about the sexuality of PID. [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]

This literature review presents a critical appraisal of the dominant approaches toward the sexuality and relationships of people with acquired brain injury. In particular, we sought to identify and review existing programs focusing on sexuality and relationships which use an educational and/or peer–peer approach. A systematic and comprehensive search of the EBSCOHOST database was conducted within an unlimited time-frame to yield the highest number of relevant results possible, along with hand-searching of key journals and databases. Reports, papers and webpages, documents commonly referred to as 'grey literature' that are not published in peer-reviewed journals, were also hand searched as a part of this review. The database search yielded 862 results, 14 of which were found to be relevant to our research interests. All of the sexuality education programs identified in this review were experienced positively by participants, families, caregivers, and professionals working with people with acquired brain injury. No peer–peer sexuality and relationships programs were identified. However, we found strong support for the use of peer–peer approaches in other programs for people with acquired brain injury. This literature review provides strong support for the development peer–peer sexuality and relationships programs for people with acquired brain injury. However, any future programs would have to overcome the limitations of existing sexuality and relationships programs. [ABSTRACT FROM AUTHOR]

The article discusses a metasynthesis approach to measure the sexual and reproductive health of people with physical disabilities in various developed and developing countries from 1995 to 2011. It mentions the emergence of four themes in the study such as reproductive health, sexual attractiveness, sexual health knowledge and sexual health issues. The research states a model to explain the internal and external factors in the reproductive and sexual life of people with physical disabilities.

This scoping review provides an overview of access to reproductive health care for women with physical disabilities in low-middle income and high-income countries from 1995 to 2017. The paper reviews 40 qualitative studies, identified by searching 10 databases including Ovid (Health and psychosocial instruments, NHS economic evaluation database), OVID MEDLINE, Pubmed, Informit (Health and Society, Health collection, Humanities and social sciences collection), ProQuest Central (ProQuest XML), CINAHL Plus (EBSCO), ScienceDirect Journal, Wiley Online Library, Google Scholar, BioMed Central. Nine main themes were identified. They included: unavailable, unreliable or dated health information; removal of participants' autonomy; limited reproduction-related education; health provider-derived barriers; systemic barriers to access; socio-economic barriers; transportation barriers; Family-related barriers; and reproductive technology barriers. These themes are explored across various country contexts, including high-income countries with high access to reproductive health care, high-income countries with low access, low-middle income countries with high access, and low-middle income countries with low access. Some suggestions for improvements are also outlined. [ABSTRACT FROM AUTHOR]

To meta-synthesize the qualitative evidence on individuals' subjective experiences of sexual health following a spinal cord injury (SCI). PubMed, EMBASE, CINAHL, and PsycInfo were searched from 1960 to 2021 for qualitative research articles that examined sexual health (i.e., sex, sexuality, reproductive health, etc.) in adults with SCI. Only studies published in English, including first-person accounts of living with a SCI were included. Using qualitative meta-synthesis methodology, data (reported results) from each selected study were coded line-by-line to develop descriptive and analytical themes by two investigators. A total of 22 studies met inclusion criteria. Some articles inquired about specific aspects of sexual health (e.g., how their sexual experiences are affected by urinary incontinence), and others inquired broadly about the experience of sexual relationships (e.g., how people engage in sexual relationships after their SCI). The themes identified in each study were positioned within the Sexual Rehabilitation Framework (Elliott 2017) composed of eight domains: sexual drive/interests, partnerships, self-image, bowel/bladder, sexual function, motor/sensory, fertility/contraception, and secondary complications. Sexual health was shown to be a significant priority for individuals after a SCI and they are impacted in a multitude of ways. Individuals report wanting education and knowledge on sexual health post SCI. Health care professionals were perceived to lack the ability to meet their needs and resources were inadequate. Further, providers' approach, attitude, and insensitivity to patient needs were perceived barriers to adequate sexual health rehabilitation post SCI. The collective findings can inform (a) rehabilitation professionals' awareness of patients' sexual needs after SCI; (b) the development of SCI programming or services for sexual health rehabilitation; and (c) the design of future research studies (e.g., interventions for specific sexual issues). [ABSTRACT FROM AUTHOR]

People with intellectual disabilities (PID) share the same needs for affectionate and intimate relationships as other people. In this study, a review of the literature was performed to (a) examine the opinions reported in the peer-reviewed literature regarding the sexual experiences of PID and (b) identify factors that contribute to the promotion or restriction of sexual expression by PID. Sixteen qualitative articles were identified from electronic databases and reviewed. People with PID were found to exhibit the same spectrum of sexual life as the general population, and three major themes were identified: abstinence, regulation, and autonomy. Some PID preferred to abstain from sex, whereas others considered engagement in sexual activity to have a hand that affects and influences the rights of PID to engage in sexual activity. Further empirical research on the empowerment of sexual expression of PID and the formation of the unintended invisible hand is needed, as this will provide information to families and welfare systems and thus enhance the self-determination and rights of PID to pursue sexual expression and satisfaction. [ABSTRACT FROM AUTHOR]

Disability is a varied experience resulting from the interaction of multiple factors: health conditions, personal, and environmental factors. People with Disabilities face various forms of discrimination within the healthcare sector, including the lack of accessible and appropriate services; information in accessible formats; coverage of communication needs; and access to information and communication technologies. Another area of hindrance is accessing sexual and reproductive health (SRH) services. This scoping review aims to identify facilitators and barriers related to accessing SRH services and the experiences of people with sensory impairment (PwSI) in them. The review includes 37 articles reporting on facilitators and barriers to SRH services. Findings include less access to SRH and awareness in how to access SRH services, mainly among young people, and less comprehensive knowledge about modern contraceptive methods possibly determined by the lack of adequate and inclusive sexual information. These results support the idea of including accessible SRH materials, training providers on the needs of people with sensory disabilities, removing barriers to sexuality education and health services, to address the disadvantages faced by PwSI and provide them with access to health care which is a basic right. [ABSTRACT FROM AUTHOR]

The sexual agency of youth with physical disabilities is often unacknowledged and underdeveloped. Concerned adults often make decisions about sexual and reproductive care for youth with physical disabilities to protect them from adverse outcomes, such as sexual abuse. Additionally, sexuality resources available to youth with physical disabilities are often not specific to their disability, which may limit their ability to foster positive sexuality. We conducted a systematic review to understand the knowledge created through qualitative inquiry on the sexuality of youth with physical disabilities. We considered qualitative or mixed-method studies published between 1999 and 2021. The electronic databases MEDLINE, PsycINFO, CINAHL, Dissertations and Theses Global were searched, as well as the DuckDuckGo search engine for grey literature. Nineteen peer-reviewed studies and 10 grey literature sources were included. Six themes were identified: (1) Sexuality resources did not adequately support the sexual rights of youth with physical disabilities, (2) Parents of youth with disabilities feared their child was sexually vulnerable, (3) Many healthcare providers felt unprepared to discuss sexuality with youth with disabilities, (4) Youth with physical disabilities experienced discrimination related to their sexuality, (5) The sexual agency of youth with physical disabilities was often unrecognized, and (6) Youth with physical disabilities had diverse sexual experiences and identities. This review revealed the complex, intersecting, and diverse experiences of youth with physical disabilities when it comes to their sexuality. Recommendations call on parents/caregivers, healthcare providers, researchers, and society at large, to combat systemic misconceptions and recognize the sexual agency of youth with physical disabilities. [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]

Sexuality and intimate relationships are topics of interest to adolescents and young adults with Autism Spectrum Disorder (ASD). Given their relative difficulties to the social dimension, several intervention programs have been developed to meet this demand, but the complexity of the reality experienced by these young people limits the effectiveness of these intervention programs. To find the effects of different intervention programs to influence the development of sexuality and sexual health of adolescents with ASD and determine the impact of these interventions on the parents, through a systematic review. Literature review conducted on November 27, 2019 in the psycINFO, Pubmed, web of science and CINAHL databases. Intervention programs consisting solely of teaching sessions improve the knowledge of the youth. However, when they also included a direct approach or homework, behavioral effects were also observable. Parent-focused intervention programs resulted in a slight increase in parents' comfort level and ability to interact well with their youth. Intervention programs targeting school-based workers appear to have a limited effect, having good concrete results with youth for some workers and no results for others, while intervention programs targeting health professionals have no conclusive results. The results of the literature review are not very transferable to practice because of the low level of evidence in the articles included, however, they offer an interesting starting point. Further research is needed to equip health professionals to intervene in sexuality after youth with ASD. [ABSTRACT FROM AUTHOR]

A scoping review was conducted to identify how peer-education models are being used in sexuality and respectful relationship education for people with a disability. The search was conducted in August 2021 using the Joanna Briggs framework to scope and map the literature and research activity. Using strict criteria, 7 online databases, grey literature and reference lists were searched for resources written or published in the last 15 years (2006–2021). Relevant sources were shortlisted and assessed by the two authors. Six sources met the criteria for inclusion in this review. In total, four educational programs are described and discussed. The results identify four sexuality and respectful relationship programs that met screening criteria: (1) "Telling it like it is!", (2) "Sexual Lives and Respectful Relationships", (3) "Talking about sex and relationships: the views of young people with learning disabilities", and (4) "Health, Safety & Sexuality Training for You & Me". Peer-educators experienced increased confidence and feelings of empowerment, while people without an intellectual disability reported a greater understanding of the challenges and experiences of people with a disability. The use of peer educators to deliver sexuality and respectful relationship education for people with intellectual disability is a promising education model with multiple potential benefits for participants. However, more research is needed to understand the consequences and limitations of such programs. [ABSTRACT FROM AUTHOR]

Staff working with individuals with Intellectual Disabilities (ID) play an important role in enabling them to fulfill their sexual and romantic needs. Given the lack of recent reviews providing a synthesis of qualitative research in this population, the present review explored how staff working with individuals with ID in a variety of capacities (e.g. support workers, service managers, nurses, educators, psychologists, social workers) perceived their role in relation to supporting sexuality and relationships. A systematic search of EMBASE, PsychINFO, MEDLINE, CINAHL, ASSIA and SCOPUS was carried out and identified articles were rated against inclusion and exclusion criteria, as well as quality criteria. Findings were analyzed using thematic synthesis. The application of criteria resulted in the inclusion of 15 articles. Four themes were identified: (a) "Attitudes towards sexuality and relationships: A right and a challenge", (b) "Responding to sexuality and relationships: A conflicted discourse", (c) "Uncertainty and lack of systemic support", and (d) "Influences on decision-making". Findings suggest that staff hold ambivalent attitudes and often respond inconsistently to issues relating to service users' sexuality. Role uncertainty, fear of accountability, lack of training and policy, as well as factors related to employing organizations and family caregivers were identified as barriers. The findings highlight the importance of providing training and supervision for staff in order to address ambivalent attitudes and anxieties, further developing national and local policy in relation to sexuality and relationships, and supporting family caregivers to meaningfully work alongside staff on issues relating to service users' sexuality. [ABSTRACT FROM AUTHOR]

Individuals with neurodevelopmental disorders, including Autism (ASD) and intellectual disability (ID), have a right and need for appropriate sexuality and relationship education (SRE). These individuals often have the same desires as typically-developing people to express their sexuality and form intimate relationships; and may have an increased risk of sexual exploitation and abuse. While there are various materials recommended for teaching SRE to these groups, there is a lack of empirical evaluation of such. A systematic review was carried out on peer-reviewed articles published in English between 1980 and March 2018 to identify what SRE programs have been evaluated empirically, highlighting their content, methods of delivery, efficacy in changing knowledge and behavioural outcomes, and limitations. Thirty-three studies were retained for inclusion which quantitatively evaluated SRE interventions delivered to individuals diagnosed with ID (approximately 63%) and ASD. Most of the studies evaluated stand-alone programs derived from mixed sources within the broader SRE literature. They focused more on biological content (e.g., anatomy, puberty, reproduction) and self-awareness/safety (e.g., boundaries, assertiveness, privacy) than personal sexuality (e.g., sexual orientation, masturbation) and relationships (e.g., dating, emotions, parenting). Most programs improved outcomes, however the overall quality of included studies was poor. Limitations included scant description of theoretical and ethical paradigms within programs and use of non-validated outcome measures. Recommendations for future research and clinical implications are discussed. [ABSTRACT FROM AUTHOR]

An integrative review of the literature reporting operational aspects (how, when, who, with what) of rehabilitation professionals' discussion of sexuality with individuals with mild to severe traumatic brain injury (TBI) was conducted. Searches were carried out in seven databases. Records published from 2000 to 2017 were screened and selected (n = 504). The methodological quality of empirical studies was evaluated using the Mixed Methods Appraisal Tool. Seventeen full-text articles, book chapters, books, and essays were included and analysed in this integrative review. Prerequisites for discussing sexuality were identified. The PLISSIT model's usefulness in getting professionals to talk about sexuality was highlighted by nine sources (52.9%). An interdisciplinary team approach, with different aspects of sexuality covered by specific professions, was principally endorsed. Five sources (29.4%) reported that the best timing to initiate a discussion about sexuality would be during early rehabilitation. Nine sources (52.9%) supported the provision of written materials or other supporting resources, such as websites and videos. To integrate sexuality as a component of TBI rehabilitation, professionals need to be aware of their role, the information and education that should be provided, the appropriate timing, the tools that might be helpful, and the support from their organizations. There is a need for more intervention studies to assess the efficacy, alternating or combining different operational aspects identified in this review. [ABSTRACT FROM AUTHOR]

This article reports on the outcomes of a comprehensive review of qualitative research using the Joanna Briggs Institute (JBI) guidelines to guide a systematic approach addressing women with physical disabilities (WWPD)'s access to and utilization of maternal health care services in low and middle-income countries. The article specifically examines existing literature on the experiences and challenges facing WWPD in accessing and utilization of these services during pregnancy, childbirth and the post-natal period. Fifteen studies that met inclusion criteria were identified. Findings from the review highlight that pregnancy and motherhood are meaningful for WWPD in both individual and socio-cultural ways. Multiple challenges facing WWPD were identified, including low self-esteem and confidence, negative responses and lack of family support, problematic experiences of transport, health and other social systems for maternal healthcare of WWPD, and social unacceptance and discrimination from the community. Addressing barriers in accessing healthcare services was perceived as an individual responsibility of WWPD and their families, rather than perceptions that society had a responsibility to act. The reproductive rights of WWPD, particularly expression of sexuality and the right to motherhood needs to be conceptualized beyond individual responsibility. Society needs to eliminate attitudinal and environmental barriers to ensure WWPD can choose to be mothers without threat of discrimination or negative social consequences. [ABSTRACT FROM AUTHOR]

The aims of this review were to systematically identify, critically appraise and synthesize the results of existing qualitative literature exploring the views and experiences of intimate relationships amongst people with intellectual disabilities. Fourteen peer-reviewed articles were identified through a systematic search of eight databases, reference lists, citations, and relevant journals. The identified articles were appraised for quality, then synthesized using a metaethnography approach. No study met all quality criteria and references to ethical approval were often lacking. Interpretation of the findings suggested three key themes: the meaning of intimate relationships, external constraints and facilitators, and managing external constraints. Though many people with intellectual disabilities desire and benefit from intimate relationships, they experience restrictions that others do not, which can lead to isolation and loneliness. Intimate relationships are not always necessarily linked with sexual behavior; therefore, intimate relationships warrant their own focus in future research, as well as in education and training for people with intellectual disabilities and their caregivers. Within this, a commitment to transparency over research processes is needed, in particular with reference to how ethical approval was obtained, since this has been a shortcoming of research with this focus to date. [ABSTRACT FROM AUTHOR]

The article presents a study which developed social stories that could be used as part of a sexuality and relationship training program for women with intellectual disabilities. Topics discussed include different phases used to develop the stories, finding on three of the four social stories, and a suggestion to re-write the story to reflect romantic relationships as opposed to dating.

The article talks about the current status and the effectivity of sexual education curricula for persons with intellectual disabilities (ID). Topics include a comprehensive review of social science literature from 1995-2015 on the effects of ineffective sexual education and literature on sexuality education for individuals with ID, and the results which show that persons with ID have a greater risk of sexual abuse, misinformation, and infection with sexually transmitted diseases (STD).