Sexual lives and reproductive health outcomes among persons with disabilities: a mixed-methods study in two districts of Ghana

Seidu, Abdul-Aziz, Malau-Aduli, Bunmi S., McBain-Rigg, Kristin, Malau-Aduli, Aduli E.O., and Emeto, Theophilus I. (2024) Sexual lives and reproductive health outcomes among persons with disabilities: a mixed-methods study in two districts of Ghana. Reproductive Health, 21. 69.

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Abstract

Introduction: People with disabilities (PwDs) constitute a large and diverse group within the global population, however, their sexual and reproductive health (SRH) needs are often neglected, particularly in low-and middle-income countries. This may result in adverse outcomes, such as sexually transmitted infections (STIs), unintended pregnancies, and experience of interpersonal violence (IV). This study aimed to assess the factors that influence the sexual lives of PwDs in two districts of Ghana.

Methods: A sequential explanatory mixed-methods study design was used to collect data from PwDs. Quantitative data were obtained from 402 respondents using a pretested questionnaire, and qualitative data gathered from 37 participants using in-depth interviews. The quantitative data were analysed using descriptive and inferential statistics, while the qualitative data were analysed using inductive thematic analysis.

Results: Most PwDs (91%) reported that they have ever had sex, which was associated with age, disability severity, and household size. The prevalence of poor SRH status, STIs, unintended pregnancy, pregnancy termination, and unsafe abortion were 10.5%, 5.7%, 6.4%, 21.6%, and 36.9% respectively. These outcomes were influenced by education, income, health insurance subscription, and proximity to a health facility. The prevalence of IV was 65%, which was related to disability type and severity. The qualitative data revealed five main themes: curiosity to engage in sexual activities, feelings of despair and insecurity with abled partners, preference for sexual relationships with other PwDs, IV and its perpetrators, and adverse SRH outcomes.

Conclusion: The study findings indicate that most adult PwDs have ever had sex and they face various challenges in their sexual lives. They experience multiple forms of abuse and neglect from different perpetrators at different levels of society, which have negative impacts on their well-being. There is a need for comprehensive and inclusive interventions that address the SRH needs of PwDs, as well as the underlying social and structural factors that contribute to their vulnerability. Further research is recommended to explore the perspectives of stakeholders on how to improve the SRH outcomes of PwDs.

Item ID: 82873
Item Type: Article (Research - C1)
ISSN: 1742-4755
Copyright Information: © The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Date Deposited: 27 May 2024 06:23
FoR Codes: 49 MATHEMATICAL SCIENCES > 4905 Statistics > 490502 Biostatistics @ 30%
42 HEALTH SCIENCES > 4206 Public health > 420602 Health equity @ 40%
42 HEALTH SCIENCES > 4206 Public health > 420606 Social determinants of health @ 30%
SEO Codes: 20 HEALTH > 2002 Evaluation of health and support services > 200207 Social structure and health @ 30%
20 HEALTH > 2004 Public health (excl. specific population health) > 200403 Disability and functional capacity @ 40%
20 HEALTH > 2002 Evaluation of health and support services > 200205 Health policy evaluation @ 30%
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