Women with spinal cord injury (SCI) often experience sexual dysfunction, however, it is underassessed and undertreated in clinical settings. This purpose of this scoping review was to characterize, synthesize and evaluate the current evidence on sexuality, sexual function, and sexual wellness among women with SCI in order to inform care practices, highlight gaps in knowledge, and guide the development of interventions to improve sexual health and well-being. The scoping review methodological framework and the PRISMA extension were used to guide the search strategy, study selection, data collection, and reporting. Searched articles related to SCI and sexuality and sexual health from 1980 to 2022. The study team synthesized the information extracted from eligible studies both descriptively and thematically. Sixty-five articles met inclusion criteria. The majority of research was conducted in high income, Western countries, and explored sexual dysfunction for women with SCI. Few studies described the development and dissemination of interventions aimed at improving sexual function or quality of life, and 91% of the studies were observational. In this 40-year period, the field of research has established a solid foundation connecting SCI with sexual dysfunction. It is time to progress the field into developing and disseminating behavioral interventions to compliment devices and drugs. These interventions may seek not only to improve sexual function, but also increase sexual self-efficacy and well-being, improve relationship satisfaction, increase self-advocacy, and provide access to educational resources and therapeutic aids that can improve sexual satisfaction and sexual quality of life for women with SCI.

Background: People with disabilities experience disproportionately high rates of sexual violence victimization. To address this inequity, sexual violence prevention programs that teach risk reductions strategies and physical self-defense skills must be accessible and inclusive for people with disabilities.

Methods: We invited college students with intellectual and developmental disabilities, their peer supports, and faculty disability experts to attend a one-hour sexual violence prevention program. Participants provided feedback on the inclusivity of the program and suggestions for improvement via a post-program survey. We conducted thematic analysis of survey responses and used the findings to modify the content and structure of the program. We then delivered the modified program and collected a second round of survey data to determine the effectiveness of the modifications.

Results: Modifications to the program included removing discussion of weapons, adding examples of how to identify and avoid potentially dangerous situations, taking a break half-way through the program, alternating between demonstration and practice of self-defense skills, and limiting the number repetitions during self-defense skills practice. After participating in the modified program, participants expressed satisfaction with the modifications, increased confidence in their ability to defend themselves, and interest in participating in additional programs.

Conclusion: Ensuring that people with intellectual and developmental disabilities have access to inclusive sexual violence prevention programs is critical to addressing the disproportionate rate of sexual violence against them. One method for achieving this goal is to modify the content, structure, and delivery of existing programs to better meet the needs of participants with disabilities.

This presentation discusses the Friendships and Dating in Oregon Transition Programs Project, a partnership between multiple entities to support healthy relationships and sexual health education in transition programs within Oregon schools. The project has been implemented in 45 schools across the state, reaching more than 300 students. Presenters will share about funding, program development, partnerships, implementation, and results.

Data show that young people with disabilities in Oregon engage in sexual activity and are less likely to use condoms and birth control, which can put them at higher risk of sexually transmitted infections (STIs) and unintended pregnancy (1). Despite the fact that youth with disabilities are sexual beings, they often do not have access to sexual health education. Research shows that sexuality education that is adapted and accessible can improve the ability of people with I/DD to make sexuality-related decisions (2).

In 2020, the University Center for Excellence in Developmental Disabilities at Oregon Health & Science University (UCEDD at OHSU) received federal funding from the Personal Responsibility Education Program (PREP) through Oregon Health Authority (OHA) for programming to support healthy relationships and sexual health education of youth and young adults with intellectual and developmental disabilities.

The project aimed to train teachers and staff in transition programs within Oregon schools to implement Friendships & Dating, a sexual health and relationships curriculum. The Friendships & Dating Program is an evidence-based, comprehensive approach to teach individuals with intellectual and developmental disabilities the skills needed to develop meaningful relationships and prevent interpersonal violence.

Background. People with disabilities are an internationally recognized priority population for HIV prevention and treatment efforts. Despite this prioritization, there is limited research on HIV care disparities among people with disabilities, and even less among people with intellectual and developmental disabilities (IDD). The purpose of this study was to conduct the largest epidemiological study to date on HIV care outcomes among people with IDD.

Methods. We used data from the Medicare-Medicaid Linked Enrollees Analytic Data Source, with a sample of 878,186 publicly insured adults with IDD in 2012. The cohort was segmented by type of IDD, and disparities in HIV care outcomes were tested with adjustments for predisposing, enabling, and need characteristics.

Results. The prevalence of HIV diagnosis ranged from 0.38% (for adults with ID only) to 1.03% (other developmental disabilities). Among adults with IDD who were living with HIV, approximately 71% had received ART during 2012. Significant disparities by race and co-occurring psychological conditions were identified across the HIV care continuum.

Conclusions. Adults with IDD are at risk of HIV-related care disparities which may be linked to ableist beliefs in public health and medical practice. Disparities in HIV-related outcomes differ by sub-group of IDD, with autistic adults with ID having poorer care outcomes. Therefore, people with IDD must be considered in HIV prevention and treatment programming and guideline development.

Background: Over 50% of pregnancies in the United States are unintended. Women with unintended pregnancies may be less likely to receive timely prenatal care and engage in healthy behaviors immediately before and during pregnancy. Limited research suggests that women with disabilities are more likely to have an unintended pregnancy, but to date no studies have assessed whether intendedness varies by extent of disability.

Methods: We analyzed 2019-2020 PRAMS data from 23 sites that included the Washington Group Short Set of Questions on Disability (n=37,832). We examined associations of extent of disability (none [reference group], some difficulty, or a lot of difficulty) with pregnancy intendedness (classified as intended [reference group], mistimed, unwanted, or unsure) using multinomial logistic regression to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) while controlling for sociodemographic characteristics.

Results: Overall, 60.1% of pregnancies were intended, 18.2% mistimed, 6.4% unwanted, and 15.3% unsure. Compared to respondents with no difficulty, respondents with some difficulty and a lot of difficulty were more likely to report a mistimed pregnancy (aOR=1.55, 95%CI 1.40,1.71; aOR=1.62, 95%CI 1.34,1.95), an unwanted pregnancy (aOR=1.92, 95%CI 1.66,2.24; aOR=2.20; 95%CI 1.72,2.82), and unsure intendedness (aOR=1.61, 95%CI 1.45,1.79; aOR=1.75, 95%CI 1.45,2.11), respectively.

Conclusions: Disabled women are more likely to report an unintended pregnancy, regardless of extent of disability. A better understanding of pregnancy intendedness in relation to disability will inform targeted intervention efforts to support healthy pregnancies and positive outcomes.