Alemu Tigist, Fantahun Mesganaw
University of California, San Diego-Ethiopia, Ethiopia.
Ethiop Med J. 2011 Apr;49(2):97-108.
Young people in Ethiopia face many sexual and reproductive health problems. In particular young people with disability are among the most stigmatized, poorest, and least educated. To date, very little is known about the sexuality of disabled youth, in general the reproductive health need and related problems of this group.
The aim of this study is to assess the sexual reproductive health status and associated problems of young people with disability at selected associations of people with disability in Addis Ababa.
A cross-sectional survey was conducted from Feb 11-17, 2008 to assess disabled youth reproductive health status and related problems. Data were collected by trained interviewers using a structured questionnaire and two complementary focus group discussions were also conducted guided by semi-structured questions. A total of 384 young people with disability were selected using systematic sampling technique. The sociodemographic and the sexual reproductive health characteristics of the respondents were described and appropriate statistical methods including chi-square test, crude and adjusted odds ratio were used to make comparisons
A total 174 (45.3%) of respondents in the study ever had sexual intercourse; out of which 100 (57.5%) and 74 (42.5%) were males and females respectively. Seventy three (42.0%) started sex between the age of 15-19 years and only 9.2% were married Only 45.4% of the sexually experienced respondents had used some kind of contraceptive during their first sexual encounter. The prevalence of unintended pregnancy was 62.5% among young disabled females who had ever been pregnant and 50% of them had history of abortion, 87.5% of this abortion was induced type. In this study, 58.6% of the sexually active respondents had multiple life time sexual partners, 20.7% had a casual sex partner and 18.0% of sexually active males had a commercial sex partner in the past 12 months period prior to the survey. The prevalence of history of ever having STI was 25.3% Only 55.5%, 33.1% and 51.8% of respondents had good knowledge on HIV transmission, STI Sign and symptom, HIV Prevention respectively and only 33.3% of respondents had utilized reproductive health services. Adjusting for socio-demographic variables, respondents' educational status, occupation, sex and forms of disability were found to have a significant association with modern contraceptive use (P < 0.05).
CONCLUSION & RECOMMENDATIONS: Young People with Disability (YPWD) are at great risk for sexual and reproductive health associated problems. Female young people with disability and the illiterate are the most disadvantaged Awareness of parents, family members and the community about the needs and the capabilities of YPWD should improve and they should work together with the government to provide a safe environment for YPWDs. Organizing programs focused on acquisition of essential skills (communication and negotiation skills) and provision of appropriate for YPWD sexual and reproductive health services deserve due emphasis.
埃塞俄比亚的年轻人面临许多性健康和生殖健康问题。特别是残疾青年是最受歧视、最贫困且受教育程度最低的群体之一。迄今为止，对于残疾青年的性取向、该群体总体的生殖健康需求及相关问题知之甚少。
本研究旨在评估亚的斯亚贝巴选定的残疾人协会中残疾青年的性生殖健康状况及相关问题。
于2008年2月11日至17日进行了一项横断面调查，以评估残疾青年的生殖健康状况及相关问题。由经过培训的访谈员使用结构化问卷收集数据，并在半结构化问题的引导下进行了两次补充性焦点小组讨论。采用系统抽样技术共选取了384名残疾青年。描述了受访者的社会人口统计学特征和性生殖健康特征，并使用包括卡方检验、粗比值比和调整后的比值比在内的适当统计方法进行比较。
研究中共有174名（45.3%）受访者曾有过性行为；其中男性100名（57.5%），女性74名（42.5%）。73名（42.0%）在15至19岁开始性行为，只有9.2%已婚。在有过性经历的受访者中，只有45.4%在首次性行为时使用过某种避孕措施。曾怀孕的残疾青年女性中意外怀孕的发生率为62.5%，其中50%有堕胎史，87.5%的堕胎为人工流产。在本研究中，58.6%有性行为的受访者有多个性伴侣，20.7%有临时性伴侣，在调查前的过去12个月中，18.0%有性行为的男性有商业性伴侣。曾感染性传播感染的发生率为25.3%。只有55.5%、33.1%和51.8%的受访者分别对艾滋病毒传播、性传播感染的体征和症状、艾滋病毒预防有充分了解，只有33.3%的受访者利用过生殖健康服务。在调整社会人口统计学变量后，发现受访者的教育程度、职业、性别和残疾形式与现代避孕方法的使用有显著关联（P<0.05）。
残疾青年面临性健康和生殖健康相关问题的巨大风险。残疾青年女性和文盲是最弱势群体。父母、家庭成员和社区应提高对残疾青年需求和能力的认识，并应与政府共同努力为残疾青年提供安全的环境。应适当重视组织侧重于获取基本技能（沟通和谈判技能）以及为残疾青年提供适当性健康和生殖健康服务的项目。
