Office on Disability
Sexually Transmitted Diseases and Disability
A COMPANION TO CHAPTER 25 OF HEALTHY PEOPLE 2010
OFFICE ON DISABILITY
The Office on Disability (OD) was created by the Secretary of the U.S. Department of Health and Human Services in October 2002. The OD acts as the focal point for programs, policies, and initiatives designed to tear down barriers that prevent the 54 million Americans with disabilities from fully participating in an inclusive community life.
PURPOSE OF THE COMPANION DOCUMENT TO HEALTHY PEOPLE 2010
Eliminating health disparities is a key goal of Healthy People 2010. Persons with disabilities are represented in 207 of the 467 Healthy People 2010 objectives, and data on persons with disabilities are available for only 88 of these 207. Each companion document describes the particular challenges to health promotion and disease prevention affecting persons with disabilities in focus areas addressed in Healthy People 2010. The importance of including persons with disabilities in research is also stressed.
HEALTHY PEOPLE 2010 GOAL
Promote responsible sexual behaviors, strengthen community capacity, and increase access to quality services to prevent sexually transmitted diseases (STDs) and their complications.
Healthy People 2010 prioritizes preventing the disproportionate incidence of STDs among youth, some racial groups, and those who are economically or socially disenfranchised. Persons with disabilities are of all ages, of all races, of all socioeconomic classes, and are marginalized in STD education and prevention efforts.
Sexually transmitted diseases (STDs) refer to the more than 25 infectious organisms transmitted primarily through sexual activity.STDs can be transmitted through vaginal, oral or anal sex. The effects of each infection differ, but in all, STDs cause harmful, often irreversible, and costly clinical complications. STDs can cause reproductive health problems including infertility, cervical and other cancers, and liver disease. Some STDs increase the risk of getting HIV/AIDS.
Persons with disabilities are at risk for STD infections
It is incorrectly assumed that persons with disabilities are not sexually active. In fact, the physical and emotional aspects of sexuality, despite the physical loss of function, continue to be just as important for persons with disabilities as for persons without disabilities. Yet individuals with disability are assumed to be at little or no risk for STD infection therefore have not typically been included in outreach efforts.
- Persons with disabilities are as likely as their peers without disabilities to be sexually active.
- Persons with disabilities are more likely than persons without disabilities to be victims of violence or rape. Further, they are less likely to obtain police intervention, legal protection, or prophylactic care.
- Persons with disabilities have often been completely excluded from sexual education.
- Health care providers may mistakenly assume that persons with disabilities are not sexually active, especially if their disability is disfiguring or severe, and neglect to screen for STDs.
- Women with disabilities may be less likely to complain of symptoms suggesting an STD because mobility and sensory impairments may prevent them from noticing a rash or vaginal discharge, or from feeling pain and itching.
- STDs are less likely to be detected and treated in women with disabilities, which increases their risk of developing more serious medical conditions including pelvic inflammatory disease, cervical cancer, HIV/AIDS, ectopic pregnancy, and infertility.
How common are STDs in the disabled population?
Little data are available on the prevalence of STDs among persons with disabilities other than anecdotal reports. However, special characteristics of this population suggest that the rate of infection could be as high as the rate found within the United States population as a whole.
- The Centers for Disease Control and Prevention (CDC) estimates that 19 million STD infections occur annually, almost half of them among youth ages 15 to 24.
- While all individuals with disability are at risk for HIV infection, subgroups within the disabled population are at an increased risk. Most notably this includes women, members of ethnic and minority communities, adolescents, and those living in institutions.
STD education, prevention, and treatment services are not accessible
Existing health care and wellness systems are not sufficiently responsive to the needs of persons with disabilities. As a result, access to education, prevention, screening, diagnosis, treatment, and services for STDs can be limited, incomplete, or misdirected.
STD prevention materials are often inaccessible to persons with disabilities.
- Health promotion materials may be written at too high a reading level for a person with an intellectual disability. According to the CDC National Prevention Information Network and the World Bank Organization, the global literacy rate for adults with disability is as low as 3%. For women with disability, the global literacy rate may be as low as 1%.
- Materials also might be unavailable in formats accessible to persons with visual impairments (e.g., Braille or interactive technology).
- STD educational and prevention literature, videos, presentations, and materials found in print media, on television, and on the World Wide Web primarily show images of persons without disabilities, sending the inaccurate message that persons with disabilities are not at risk.
Clinics and services are often inaccessible to those with physical disabilities.
- Transportation issues and sheer distance complicate access to specialized treatment centers for persons with disabilities.
- Once at a health care facility, other potential physical barriers arise. Frequently, treatment centers do not have adaptive equipment that can meet the needs of individuals with disabilities, including changing rooms with narrow doorways and examination tables too high or too flat for comfort. More than discomfort, the result might well be an incomplete, potentially inaccurate, examination.
- Cultural insensitivity by health care and health promotion providers may prevent persons with disabilities from seeking education, testing, and care for STDs.
- Effective communication may be frustrated as a result of limited availability of assistive supports, such as interpreters for persons who are deaf or hard of hearing.
- Because health care and health promotion providers alike often focus solely on a person’s disability rather than on the full range of health and wellness needs, they may fail to communicate STD prevention messages that are given routinely to persons without disablities.
- Health care and wellness providers might not know how to educate persons with disabilities that compromise mobility, vision, sensation, or cognition about how best to recognize early symptoms of STDs.
- Persons with disabilities need access to STD prevention materials that are culturally sensitive, linguistically accessible, and inclusive in order to meet their prevention needs.
- Persons with disabilities should be included in research and data statistics.
To Learn More…
CDC National Prevention Information Network (NPIN)
CDC STD information and Referrals