The myth of asexuality? Disability stigma as a barrier to sexual relationships in South Africa Literature review
Section B: Access to sexual and reproductive healthcare
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Section B: Access to sexual and reproductive healthcareSection B lists applied research which primarily investigates access toward sexual and reproductive healthcare. This includes empirical data on people’s beliefs and experiences of healthcare services, as well as studies that seek to identify barriers and facilitators of access. Several studies test interventions to improve access, by either targeting the experiences of persons with disabilities, or the experiences that professionals have in delivering sexuality education. A few notable papers review sexual and reproductive healthcare access within different areas of Africa (e.g., countries, regions), although the methodologies used in each case differ (e.g., interviews; meta- analyses).Studies also tend to focus on the first-person experiences that persons with physical disabilities face when accessing healthcare services. i): World
Aderemi et al. investigate predictors of HIV counselling among persons with disabilities (N = 411) in Ethiopia. Testing prevalence was 53.2% and knowledge, cohabitation with a spouse and religiosity were identified as positive predictors of testing.
The authors qualitatively investigate barriers to persons with disabilities accessing healthcare services in Uganda, using interviews. Findings identify such as barriers as negative attitudes, long queues at facilities, high costs and inaccessible buildings. The authors suggest this highlights the need to provide disability friendly services at these facilities (see also Anderson & Kitchin, 2000).
The authors investigate the prevalence of abuse among outpatient women with disabilities (N = 75) and its link with healthcare utilization and pain medication usage. 35 patients reported sexual abuse and abuse history was linked to greater healthcare usage and greater pain medication usage.
Anderson and Kitchin investigate access to family planning clinics among persons with disabilities in Northern Ireland. They identify a number of barriers to access (e.g., physical structures, attitudes) that suggests there exists a “culture of exclusion” of the disabled from healthcare.
This descriptive study investigates sexual knowledge and beliefs among a small sample of physically disabled adolescents (N = 29).
Bitzer et al. develop a psychometric tool to help physicians assess sexual problems and issues among women with chronic health conditions.
This paper reports on a needs assessment conducted with spinal rehabilitation professionals (N = 90). Results highlight a number of areas for future focus, such as the promotion of staff comfort.
Christopherson et al. experimentally assess the added value of counselling when combined with written materials concerning sexual dysfunction in multiple sclerosis patients. Both groups experienced reduced sexual dysfunction post-intervention, suggesting that nurses need not apply in-depth specialised knowledge to improve quality of life.
The paper presents a biographical interview with a disabled participant about her experience of reproductive technologies.
De Beaudrap et al’s meta-analysis provides strong empirical evidence that persons with disabilities do not have a decreased risk of HIV infection, in particular highlighting that women with disabilities are most likely to be affected by the disease.
De Beaudrap et al. employ a mixed methodological design in order to better understand the vulnerabilities that persons with disabilities in Cameroon may experience toward HIV. The authors suggest that their methodology may contribute to the development of good practice when conducting future quantitative surveys with persons with disabilities.
Haboubi and Lincoln assess health professionals’ (N = 813) views toward delivering sexual healthcare to persons with disabilities. Findings indicated gaps in professionals’ knowledge and training, suggesting that further sexuality training should be implemented.
Hess et al. focus on the rehabilitation experiences of four males with spinal cord injuries, finding that each client had found the healthcare process relatively positive.
Higgins et al. evaluate the effectiveness of a 1 day sexuality education programme for personnel working with persons with disabilities, using a pre- vs. post-test. Results suggest the programme was effective at promoting knowledge, skill and comfort among healthcare professionals.
This study evaluates the pilot implementation of a group program for young adults with physical disabilities.
This study addresses a gap in the literature, by testing a group skill model of dating and relationships to individuals with spinal cord injuries.
This authors evaluate the efficacy of psychosexual therapy for persons with physical impairments. Although based on a small sample, the findings indicate some of benefits of psychosexual therapy.
Kemp & Mallinckrodt experimentally assess the impact of disability status on the way that clients are viewed.
Kendall et al. develop a scale to assess the training needs of rehabilitation professionals addressing clients’ sexuality needs.
Lee & Oh investigate the experiences and needs of mothers with disabilities in South Korea, shedding light on an under-researched context. The study highlights a wide range of barriers (e.g., lack of competence of healthcare professionals) that these women face.
Leibowitz explores the experiences and concerns of women with disabilities related to sexual rehabilitation (N = 24), using semi-structured interviews. Results highlight the value of participant feedback on the conduct and competence of healthcare professionals.
The authors conduct a critical ethnography study investigating the experiences of nurses that provide sexual healthcare to adolescents with disabilities. They identify some barriers (e.g., institutional space), which the authors argue facilities need to take steps to address.
This study qualitatively explores the experiences with sexual rehabilitation that persons with disabilities have. Like other studies (e.g., Haboubi & Lincoln, 2003), findings point to extant training needs in this area.
O’Dea et al. compare sexuality experiences and expression between persons with neuromuscular disorders and persons without disabilities. The study also investigates sexual expression as a predictor of patient quality of life. A positive relationship was identified between the two, which was strongest among the persons with neuro-muscular disorders.
Oladunni investigates sexual behaviour and practices among youth with disabilities in Nigeria (N = 140). Findings indicate that although over half had engaged in sexual intercourse, they had little access to HIV testing and counselling, mirroring problems in different contexts, particularly African (e.g., Ethiopia; Aderemi et al., 2014).
Pebdani et al. investigate the barriers facing women who have spinal cord injuries (N = 253) and pursue pregnancy and motherhood.
Pendergrass et al. conduct a pilot study to evaluate whether an internet site can sufficiently educate women with disabilities on reproductive healthcare. Findings indicate both that women with disabilities possess gaps in their knowledge of reproductive healthcare and that the internet site was effective at addressing these gaps.
Porat et al. evaluate a service designed to provide sexual counselling to youth with disabilities. The authors identify that usage of the service was hampered by a lack of suitable transportation, highlighting the need to consider accessible transportation as part of sexual healthcare services.
Post et al. evaluate an intervention designed to increase the competence of professionals who deal with sexual rehabilitation. Additionally, they compare competence of professionals across different healthcare disciplines.
Rueda et al. qualitatively investigate the needs of social workers who support adolescents with disabilities in relation to dating and sexual health. The authors suggest that challenges exist at both the school level (e.g., need for school-based education programmes) and within the broader environment (e.g., unhealthy cultural depictions of sex).
This study investigates the sexual and reproductive health experiences and attitudes among youth who have spina bifida. Similar to other studies that have investigated sexuality among persons with disabilities (e.g., Oladunni, 2012) a large percentage of respondents (60%) were in intimate relationships, but almost all (95%) thought they possessed inadequate sexual knowledge.
Seburg et al. compare the likelihood of discussing health-related behaviours (including sexual and reproductive healthcare) between youth with disabilities and healthcare providers. The authors emphasise the importance of healthcare providers viewing the needs of youth with disabilities similarly to those without disabilities.
Seidel conduct a systematic review to assess how sexuality is provided for physically disabled adolescents, encompassing nine papers. While it was discovered that adolescents generally receive sexual education in schools, very little of this information was impairment-specific, highlighting the need to include more specialised, as well as general, material.
Smith et al. assess how well services in Lusaka, Zambia, can provide sexual and reproductive healthcare to women with disabilities. Findings identified several barriers to effective healthcare, in common with several other papers conducted within different countries in Africa (e.g., Ahumuzu et al. 2014; Oladunni, 2012).
Sorsa investigates health problems among children with disabilities in Ethiopia, identifying, among others, that their access to HIV treatment is restricted and they are vulnerable to sexual abuse.
The authors examine patient (N = 268) counselling preferences post-stroke. They note that patient preferences for the timing of counselling vary, creating challenges for optimizing this type of care.
Stevens et al. investigate psychosocial risks to health among adolescents with disabilities, identifying gaps in their knowledge of sexuality, similar to other work with persons with disabilities (e.g., Pendergrass et al. 2001).
Tanabe et al. conduct a participatory research project with refugees who have disabilities across three developing countries. The authors suggest that their findings speak to the need to recognise the sexual and reproductive health rights of disabled refugees.
Thomas investigates the healthcare encounters of women with disabilities by collecting women’s narratives (N = 68) and conducting in-depth interviews (N = 17).
Van der Stege et al. assess effectiveness of an intervention (SeCZ TaLK) to facilitate discussion about sexual health among young with chronic disabilities (N = 85). Results indicate that the majority of youth found the tool useful in promoting discussion.
The authors report a descriptive study investigating the sexual problems of a sample of young adults with cerebral palsy (N = 74).
Xenakis et al. evaluate the efficacy of a programme to promote healthy lifestyles (including sexuality) among women with disabilities. Findings suggest response to the programme was generally favourable.
Like other studies in the area (Oladunni, 2012; Smith et al. 2004), Yousafzai et al. report work that illustrates that the HIV epidemic among persons with disabilities is a neglected area. ii) South Africa
See Reading Note 4 p.21
See Reading Note 8 p.29
Although this Master’s thesis is focused on the general health needs of youth with physical disabilities in Durban, Njoki finds that individuals desire more information about sexuality issues. This agrees with extant peer-reviewed work (e.g., Mavuso & Maharaj, 2015).
See Reading Note 12 p.35 1 Field stakeholders Persons with disabilities, their families, and their representative organisations. Any Human Rights organisation working with persons with disabilities. Service providers and other organisations working with Persons with disabilities. Service providers and other organisations working in mainstream that are required to the meet the needs of persons with disabilities such as architects, teachers, companies, industries etc. Researchers and research institutes. Local, national and international decision makers. 2 Means of application Shaping of the findings and knowledge gained from applied research into products, services and contents to meet the expectations and needs of people with disabilities. These application supports are adjusted to be used by field stakeholders. Yüklə 285,89 Kb. Dostları ilə paylaş:
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