Greenwood Nechama W, Wilkinson Joanne
Department of Family Medicine, Boston University School of Medicine, Dowling 5, 771 Albany Street, Boston, MA 02118, USA.
Department of Family Medicine, Boston University School of Medicine, Dowling 5, 771 Albany Street, Boston, MA 02118, USA ; Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th floor, Boston, MA 02118, USA.
Int J Family Med. 2013;2013:642472. doi: 10.1155/2013/642472. Epub 2013 Dec 12.
Adults with intellectual disabilities (ID) face multiple health disparities and challenges to accessing health care. Little is known about sexual health care of this population and about how to optimize women's reproductive health care for women with intellectual disabilities. Women with ID face important barriers to care, including lack of provider training and experience, hesitancy to broach the topic of sexual health, a lack of sexual knowledge and limited opportunities for sex education, disability-related barriers, higher prevalence of sexual abuse and assault, often underreported, lack of dialogue around this population's human right to consensual sexual expression, undertreatment of menstrual disorders, and legal and systemic barriers. We conducted a limited literature review related to six aspects of sexual health care of women with ID, including barriers to sexual health care, sex education, sexual abuse and consensual sexuality, contraception, screening for sexually transmitted infections and cervical cancer, and pregnancy and parenting. After providing background information about each topic, we suggest practice recommendations for primary care clinicians, using a rights-based framework.
成年智障人士面临多种健康差距以及获得医疗保健方面的挑战。对于这一人群的性健康护理以及如何优化智障女性的生殖健康护理，人们知之甚少。智障女性在获得护理方面面临重大障碍，包括提供者缺乏培训和经验、对性健康话题难以启齿、缺乏性知识以及性教育机会有限、与残疾相关的障碍、性虐待和性侵犯的发生率较高（且往往报告不足）、围绕这一人群同意性行为的人权缺乏对话、月经失调治疗不足以及法律和制度障碍。我们针对智障女性性健康护理的六个方面进行了有限的文献综述，包括性健康护理障碍、性教育、性虐待和自愿性行为、避孕、性传播感染和宫颈癌筛查以及怀孕和育儿。在提供每个主题的背景信息后，我们使用基于权利的框架为初级保健临床医生提出实践建议。
