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限制残疾的年轻成年人的性行为和性健康结果:来自第三次英国全国性态度和生活方式调查(Natsal-3)的发现。

Sexual behaviours and sexual health outcomes among young adults with limiting disabilities: findings from third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3).

机构信息

Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.

Infection and Population Health, University College London, London, UK.

出版信息

BMJ Open. 2018 Jul 5;8(7):e019219. doi: 10.1136/bmjopen-2017-019219.

Abstract

OBJECTIVE

To explore whether the sexual behaviours and sexual health outcomes of young adults with self-reported disabilities that they perceive limit their activities ('limiting disability') differ from those without disability.

DESIGN

Complex survey analyses of cross-sectional probability sample survey data collected between September 2010 and August 2012 using computer-assisted personal interviewing and computer-assisted self-interview.

SETTING

British general population.

PARTICIPANTS

7435 women and men aged 17-34 years, resident in private households in Britain, interviewed for the third National Survey of Sexual Attitudes and Lifestyles.

MAIN OUTCOME MEASURES

Self-reported sexual behaviour and sexual health outcomes.

RESULTS

Approximately 1 in 10 participants reported having a limiting disability. Sexual behaviours were similar between those with limiting disability and those without, with a few exceptions. Women and men with limiting disability were less likely to report having sexual partner(s) (past year, adjusted ORs (AORs) for age and social class: AORs: 0.71, 0.75, respectively). Women with limiting disability were more likely to report having same-sex partner(s) in the past 5 years (AOR: 2.39). Differences were seen in sexual health outcomes, especially among women; those with limiting disability were more likely to report having experienced non-volitional sex (ever, AOR: 3.08), STI diagnoses (ever, AOR: 1.43) and sought help/advice regarding their sex life (past year, AOR: 1.56). Women with limiting disability were also more likely to feel distressed/worried about their sex life than those without limiting disability (AORs: 1.61). None of these associations were seen in men.

CONCLUSIONS

Young adults with limiting disability, especially women, are more likely to report adverse sexual health outcomes than those without, despite comparatively few behavioural differences. It is important to ensure that people with disabilities are included in sexual health promotion and service planning, and targeted policy and programme interventions are needed to address negative sexual health outcomes disproportionally experienced by people with disabilities.

摘要

目的

探讨自我报告的活动受限残疾对年轻人性行为和性健康结果的影响是否与无残疾者不同。

设计

使用计算机辅助个人访谈和计算机辅助自我访谈,对 2010 年 9 月至 2012 年 8 月间收集的横断面概率抽样调查数据进行复杂的调查分析。

地点

英国普通人群。

参与者

7435 名年龄在 17-34 岁之间、居住在英国私人住宅中的男女,接受第三次全国性态度和生活方式调查的采访。

主要观察指标

自我报告的性行为和性健康结果。

结果

约 10%的参与者报告存在活动受限残疾。除了一些例外,有活动受限残疾者和无残疾者的性行为相似。有活动受限残疾的女性和男性报告在过去一年中拥有性伴侣的可能性较小(年龄和社会阶层调整后的比值比(ORs):ORs:0.71,0.75)。在过去 5 年内,有活动受限残疾的女性更有可能报告有同性伴侣(OR:2.39)。在性健康结果方面存在差异,尤其是在女性中;有活动受限残疾者更有可能报告经历过非自愿性行为(既往,OR:3.08)、性传播感染(既往,OR:1.43),并寻求过有关性生活的帮助/建议(过去一年,OR:1.56)。有活动受限残疾的女性也比没有活动受限残疾的女性更有可能对性生活感到苦恼/担忧(ORs:1.61)。这些关联在男性中均未见。

结论

与无残疾者相比,有活动受限残疾的年轻人,尤其是女性,更有可能报告不良的性健康结果,尽管行为差异相对较少。确保将残疾人纳入性健康促进和服务规划非常重要,需要有针对性的政策和方案干预措施来解决残疾人不成比例地经历的负面性健康结果。

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