"When I was going through my separation, I realized that my ex-spouse at the time was involved in other relationships and he ended up giving me a venereal disease in the process. It was venereal warts. I was miserable. They (gynecologists) said this (treatment) will take care of it, and you'll never have it again. I did not know that it (warts) was continuous. They did not say that this you would have for the rest of your life and that it could flare up again and that you could pass it on. When I began to read current information about it, that's when I totally got upset. I wanted to make sure I was safe, and not only safe, but my (next) partner was safe." [43-year-old woman with rheumatoid arthritis]
Health care providers may mistakenly assume that women with disabilities are not sexually active, especially if their disability is disfiguring or severe, and neglect to screen for sexually transmitted diseases, or STDs. Women with disabilities may be less likely to complain of symptoms suggesting an STD because mobility and sensory impairments may prevent them from noticing a rash or vaginal discharge, or from feeling pain and itching.
Therefore, STDs are less likely to be detected and treated in women with disabilities, which could put them in jeopardy of getting pelvic inflammatory disease, or PID and increasing their risk of cervical cancer, contracting HIV, ectopic pregnancy, and infertility. We asked women who participated in this study to indicate whether or not they had experienced sexually transmitted disease at any time in their lives, and if so, the type of STD.
Results
Our study dispelled this myth of asexuality in that most of the women with disabilities had been sexually active (94 percent), making them as susceptible as women without disabilities to getting STDs. In fact, the prevalence of STDs overall was similar in the two groups, slightly more than one-fifth of the sample. Women with and without disabilities were about equally likely to have had syphilis (.4 percent vs. .5 percent), gonorrhea (4 percent vs. 5 percent), chlamydia (7 percent each), Trichomonas (11 percent each), genital warts (8 percent vs. 10 percent), or pubic lice (11 percent each). However, women with disabilities were significantly less likely to have had genital herpes (3 percent vs. 7 percent) or a non-specific STD (3 percent vs. 5 percent). No one in either group reported being HIV positive. These rates may be higher in both groups, since STDs tend to be under-reported and medical records were not available to corroborate the self-reported data. It is also possible that fewer cases have been detected among women with disabilities because they may be less likely to report symptoms, and physicians who perceive a lack of risk for STD's may not test for them.
Conclusion
Our findings indicate that getting information about STDs and safe sex practices is as important for women with disabilities as it is for any sexually active woman. Health care providers should not wait until the woman brings up the subject because some women with early-onset disabilities may have been sheltered from getting sexually related information, or may have grown up believing that their bodies are so different from able bodies that they are not susceptible to getting the same diseases. Also, because of lack of sensation or the inability to notice unusual vaginal discharge or sores, women may not be prompted to seek medical attention until symptoms have reached an advanced stage, when complications are much more likely. Illustrations in consumer literature about STDs should include women with disabilities to help dispel misconceptions and lack of awareness.
