Research

Sexually Transmitted Infections and Disabilities

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Sexually transmitted diseases are infections of your reproductive organs. Sexually transmitted diseases are very serious. They can make you very, very sick, and can leave you sterile. Some STIs, such as HIV, are deadly, and some, such as herpes, are incurable.

STIs are a common problem. Approximately 12 million new cases of sexually transmitted diseases are diagnosed each year in the United States. Between 25-50 percent of Americans will contract an STI at some point in their lives. Women account for about half of all sexually transmitted infections that occur each year, and they suffer more frequent and severe long-term consequences than men. Most STIs are more easily transmitted to women than to men. Women are twice as likely as men to get gonorrhea, hepatitis B, and HIV (AIDS). While many people associate getting an STI with being young, postmenopausal women with low estrogen levels are actually at greater risk of these infections invading easily torn vaginal tissue. Women with disabilities have the same rates of sexually transmitted diseases as other women.

However, the good news is that you can protect yourself against STIs. In addition, some bacterial STIs, like gonorrhea, chlamydia, and syphilis, are relatively easy to cure with antibiotics if they are caught early. Viral STIs, like genital herpes, genital warts, hepatitis B, and HIV, cannot be cured; however, the symptoms can be treated and controlled.

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When you have genital, anal, or oral contact with a person who has an STI, you can become infected. You only have to have contact with an infected area of another person to become sick yourself. This means you can get an STI without actually having intercourse. If the blood of people with HIV or hepatitis B gets into your body, you can become infected also.

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How Do You Protect Yourself from STIs?

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Be careful about your partners. Ask your partner about his or her sexual history. If you think you or your partner has a sexually transmitted infection, you need to see a health care provider for testing, counseling, and treatment. Remember that your partner can be infected and NOT LOOK SICK. Furthermore, an infected partner will not always know or disclose that he or she is infected with an STI. You should look closely to see if your partner has any sign of an STI -- a rash, a sore, redness, or discharge in the genital area. If you see anything you're worried about, don't have sex with that person!

Use a latex condom every time you have sexual contact. While they are not 100 percent effective, condoms greatly reduce your risk. A 1993 study showed that using condoms every time prevented HIV transmission for all but two out of 171 women with male partners who had HIV. However, eight out of 55 women became infected when their partners did not use a condom every time.

Use a foam, cream, or jelly with spermicide. These chemicals kill most STI organisms. Remember not to use a petroleum based lubricant like Vaseline or baby oil with a latex condom. It will cause the condom to dissolve!

Don't share vibrators or other sex toys.

Be careful about the alcohol or drugs you take. Alcohol and drugs are often factors when people have risky sex because they weaken good judgment and self-control. Don't make a mistake that could kill you because of alcohol and drugs.

Get a Hepatitis B immunization. The vaccine is safe and effective. Hepatitis B is a serious and sometimes fatal sexually transmitted infection.

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What Are the Symptoms of an STI?

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A woman with disabilities who has a damaging STI may have no symptoms at all. Thus, if you have engaged in unprotected sex and think you might have an STI, you should go to a health care provider to be tested.

If you have a spinal cord injury and you get an STI, you may also have symptoms and signs of autonomic dysreflexia. If you are having these kinds of problems and think you may have an STI, always tell your health care provider. An STI can cause the following symptoms in the genital area. If you are experiencing any of these symptoms, you should see your health care provider right away.

  • Abnormal or foul smelling vaginal discharge
  • Blisters, growths, or other sores
  • Itching, burning, pain
  • Menstrual irregularities
  • Painful intercourse
  • Rashes
  • Swelling
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An STI may also cause symptoms that do not show up in the genital area, but affect your whole body. If any of the following symptoms persist, you should see your health care provider. These symptoms need to be treated, regardless of whether or not they are due to an STI.

  • abdominal pain
  • aching joints
  • appetite loss
  • bowel problems
  • chills
  • coating of the mouth, throat, or vagina
  • cough
  • diarrhea
  • discolored skin
  • fatigue, feeling run down
  • fever
  • general weakness
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  • Growths
  • Hair loss
  • Hearing loss
  • Headache
  • Yellow skin
  • Mental disorder
  • Muscular pain
  • Nausea
  • Night sweats
  • Sore throat
  • Swollen glands
  • Vision loss
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  • Vomiting
  • Weight loss that is constant, rapid or unexplained
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Why Is It Sometimes Hard to Tell if a Woman With a Disability Has an STI?

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For several reasons, STIs often go undetected or diagnosis is delayed in women with disabilities, leading to preventable pelvic inflammatory disease and infertility.

Women with disabilities may not detect signs and symptoms of STIs, or they may mistake them for urinary tract infections, if they are unable to see them or feel discomfort from them.

Doctors who assume women with disabilities are not sexually active may fail to screen for STIs or educate them about safe sex practices.

Women with disabilities are discouraged from getting screened for STIs by inaccessible doctors' offices, difficulty getting onto the examination table, or previous experience with doctors not knowing how to handle disability-related symptoms during the exam, such as spasticity, imbalance, and autonomic dysreflexia.

Women with disabilities may not take medication prescribed for their STIs because they cannot swallow pills or open the bottle, and no alternatives were offered.

Presence of an STI may be a sign of sexual abuse, particularly in women with cognitive impairments, who live in institutions, or who need assistance with personal care.