Providing culturally sensitive sexual medicine for persons with disabilities: a scoping review.

Abstract

Introduction: Persons with physical disabilities (PWD) are a health care disparity group who face both difficulties accessing and inequalities in care. Although their sexual health is impacted by their disability and important to them, they often receive no or inadequate sexual health care. To address this gap, we sought to summarize evidence-based recommendations for culturally sensitive sexual health care for PWD.

Objectives: The aim of this scoping review was to identify patient-reported preferences for culturally sensitive sexual health care for people with Parkinson's Disease, Multiple Sclerosis, Spinal Cord Injury, Spina Bifida, and Cerebral Palsy.

Methods: Utilizing PubMed and Embase, we identified all primary research studies published from 1/1/2005-1/6/2024 that included PWD-reported preferences for delivery of sexual health care. After determining eligibility, two authors extracted and subsequently summarized the data utilizing standard scoping review methods.

Results: 6575 articles were identified, of which 32 met eligibility criteria, which included 13 reviews, nine cross- sectional studies, nine cohort studies, and one quasi-experimental studies. Sexual health generally goes unaddressed in the care of PWD despite its importance to the individuals. While there is a paucity of research, existing evidence suggests that preferences are highly individual and may vary by sociocultural, health, disability, relationship, and personal factors. Health care providers should ask each person about their preferences for the timing and context of sexual health conversations, such as who is present and how to make the person comfortable during the clinic visit. Validated questionnaires and educational tools may help facilitate conversations. Sexual health conversations should be ongoing.

Conclusions: Providing culturally sensitive sexual health care for PWD and their partners is both critical and feasible. Additional research is needed to further explore preferences for care and how preferences are impacted by the intersectionality of sociocultural, disability, and other factors.