Socio-demographic characteristics of study participants
A total of 685 reproductive-age people with disabilities participated in this study, with a 98.99% response rate. The mean (SD) age of the study participants was 30.9 (12.15) years. Among the study participants, 52.7% had no formal education (illiterate), and 98.37% were not employed. Half (50.2%) of the reproductive-age people with disabilities were married, and 57.8% of the participants were males.
- 52.7% had no formal education (illiterate)
- 98.37% were not employed
- 50.2% were married
- 57.8% were males
Sexual practice and history of people with disabilities
The overall prevalence of sexual practice among reproductive-age people with disabilities was 59.9% (95% CI: 56.1, 63.5), of which 30.8% (95% CI: 27.4, 34.4) were males and 29.1% (95% CI: 25.7, 32.6) were females with disabilities.
- 59.9% overall prevalence of sexual practice
- 30.8% males with disabilities
- 29.1% females with disabilities
Sexual practice by sex and types of disability
Among people with vision disabilities, 118 (77 males and 41 females), with hearing disabilities, 122 (48 males and 74 females), with extremity paralysis, 130 (58 males and 72 females), and with wheel-chair disabilities, 40 (28 males and 12 females) had a sexual practice. The chi-square test showed that there is a statistically significant sexual practice difference by type of disability.
Sexual life experience of people with disabilities
The qualitative finding revealed different sexual life experiences among people with disabilities. Despite their positive attitude toward sexual life, people with disabilities face many challenges in finding a boyfriend or girlfriend due to community discrimination and stigma about their sexual life. One of the difficulties they face in making friends and maintaining long-term relationships is a lack of financial resources. Even the dowry issue is one of their challenges. People with disabilities use friends, mothers, and others as mediators to get a girlfriend or boyfriend.
“Due to discrimination from the community, including family members and low economic income, it is difficult for me (people with disabilities) to have a sexual partner and maintain long-term relationships. (Participant number 6, male extremity disability during the in-depth interview)”
Factors associated with sexual practice
Random effect model
In the zero model (model I), 66% of the variability in sexual practice was at the community level (kebele level). This may be attributable to other unobserved community factors (ICC = 0.66), which were supported by the chi-square test (P < 0.001). This finding also showed that using a multilevel analysis model is reasonable.
Fixed effect model
In the bivariable logistic regression, sex, residence, educational status, occupation, self-perception, types of disability, wealth index, parent marital status, and Kebele’s economic status were significantly associated with the sexual practice, but after adjusting for the confounding factors, sex, occupation, self-perception, economic status, and types of disability were significantly associated with the sexual practice.
- Reproductive-age females with a disability had three (AOR = 2.81; 95% CI: 1.70, 4.62) times higher odds of sexual practice compared with reproductive-age males with disabilities.
- People with disabilities who had an occupation had an eight (AOR = 7.55; 95% CI: 4.03, 14.1) times higher probability of sexual practice compared with those who had no occupation.
- People with disabilities and those in wheelchairs were 73% (AOR = 0.27; 95% CI: 0.09, 0.82) less likely to practice sexual intercourse compared with vision disabilities.
- People with disabilities who had a good self-perception were 54% (AOR = 0.46; 95% CI: 0.28, 0.77) less likely to practice sexual intercourse compared with those who had a bad self-perception.
- Reproductive-aged people with disabilities who had a rich economic status had two (AOR = 2.05; 95% CI: 1.08, 3.89) times higher odds of sexual practice compared with those who had a poor economic status.
Sexual practice facilitators and barriers
The qualitative finding discovered different sexual practice facilitators and barriers. Sexuality-related training, information, and advice from disability associations, healthcare providers, peer groups, and religious leaders are the facilitators of sexual practice.
“My facilitator for my sexual practice was my health care providers’ advice; training about sexual life from Cheshire Ethiopia; and information from disability associations and peer groups. (Participant number 2, female with walking disability during the in-depth interview)”. But community discrimination, uncomfortable positions during intercourse, low economic income (lack of work access), and cultural influences were the barriers to sexual life. “Discrimination from the community, including my family members, and low income are the main barriers to my sexual practice. Due to the fear of being blamed by the community, it is difficult to get a girlfriend. Participant number 5 (a male in a wheelchair during the in-depth interview)”.
SDGs, Targets, and Indicators Analysis
1. Which SDGs are addressed or connected to the issues highlighted in the article?
- SDG 3: Good Health and Well-being
- SDG 4: Quality Education
- SDG 5: Gender Equality
- SDG 8: Decent Work and Economic Growth
- SDG 10: Reduced Inequalities
- SDG 16: Peace, Justice, and Strong Institutions
2. What specific targets under those SDGs can be identified based on the article’s content?
- SDG 3.7: By 2030, ensure universal access to sexual and reproductive healthcare services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs.
- SDG 4.1: By 2030, ensure that all girls and boys complete free, equitable, and quality primary and secondary education leading to relevant and effective learning outcomes.
- SDG 5.1: End all forms of discrimination against all women and girls everywhere.
- SDG 8.5: By 2030, achieve full and productive employment and decent work for all women and men, including for young people and persons with disabilities, and equal pay for work of equal value.
- SDG 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion, or economic or other status.
- SDG 16.7: Ensure responsive, inclusive, participatory, and representative decision-making at all levels.
3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?
- Indicator for SDG 3.7: Percentage of reproductive-age people with disabilities who have access to sexual and reproductive healthcare services.
- Indicator for SDG 4.1: Percentage of reproductive-age people with disabilities who have completed primary and secondary education.
- Indicator for SDG 5.1: Percentage of reproductive-age people with disabilities who experience discrimination based on their disability and gender.
- Indicator for SDG 8.5: Percentage of reproductive-age people with disabilities who are employed and receive equal pay for work of equal value.
- Indicator for SDG 10.2: Percentage of reproductive-age people with disabilities who have social, economic, and political inclusion.
- Indicator for SDG 16.7: Percentage of reproductive-age people with disabilities who participate in decision-making processes at all levels.
Table: SDGs, Targets, and Indicators
| SDGs | Targets | Indicators |
|---|---|---|
| SDG 3: Good Health and Well-being | Target 3.7: Ensure universal access to sexual and reproductive healthcare services | Percentage of reproductive-age people with disabilities who have access to sexual and reproductive healthcare services |
| SDG 4: Quality Education | Target 4.1: Ensure that all girls and boys complete free, equitable, and quality primary and secondary education | Percentage of reproductive-age people with disabilities who have completed primary and secondary education |
| SDG 5: Gender Equality | Target 5.1: End all forms of discrimination against all women and girls | Percentage of reproductive-age people with disabilities who experience discrimination based on their disability and gender |
| SDG 8: Decent Work and Economic Growth | Target 8.5: Achieve full and productive employment and decent work for all | Percentage of reproductive-age people with disabilities who are employed and receive equal pay for work of equal value |
| SDG 10: Reduced Inequalities | Target 10.2: Empower and promote the social, economic, and political inclusion of all | Percentage of reproductive-age people with disabilities who have social, economic, and political inclusion |
| SDG 16: Peace, Justice, and Strong Institutions | Target 16.7: Ensure responsive, inclusive, participatory, and representative decision-making at all levels | Percentage of reproductive-age people with disabilities who participate in decision-making processes at all levels |
Behold! This splendid article springs forth from the wellspring of knowledge, shaped by a wondrous proprietary AI technology that delved into a vast ocean of data, illuminating the path towards the Sustainable Development Goals. Remember that all rights are reserved by SDG Investors LLC, empowering us to champion progress together.
Source: bmcpublichealth.biomedcentral.com
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