Sexual abstinence and HIV knowledge in school-going adolescents with intellectual disabilities and non-disabled adolescents in Nigeria

OBJECTIVE

The study compared sexual practices and predictors of sexual abstinence among adolescent learners with mild/moderate intellectual impairments and their non-disabled peers in Nigeria.

METHOD

This was a comparative, cross-sectional survey that assessed sexual practices of learners with mild/moderate intellectual impairments (N = 300) and non-disabled learners (N = 300), aged 12-19 years, in Oyo State, Nigeria. Data were analysed using SPSS 15.0.

RESULTS

Findings indicated that learners with mild/moderate intellectual impairments abstained from sex less than non-disabled adolescents (p = 0.002). Girls with intellectual disabilities were almost four times more likely to report history of rape than non-disabled girls. There was no significant difference between sexually abstinent and sexually experienced learners with intellectual disabilities (p = 0.671) and non-disabled adolescents (p = 0.181) in their mean HIV transmission knowledge scores. Many factors, including being male, social supports and self-efficacy determined sexual abstinence among adolescents.

CONCLUSIONS

Although sexual abstinence is the recommended HIV-prevention strategy in HIV prevention curriculum in Nigerian schools, findings of this study suggested that sexual abstinence alone may not be effective for adolescent learners with intellectual disabilities. Interventions targeting youth with intellectual disabilities should consider all these factors.

Personal experience and perception of abuse in people with intellectual disabilities

This article presents a qualitative study designed to gain insight into personal experience and perception of abuse in people with intellectual disabilities. Ten members of the organization for people with intellectual disabilities in Zadar, Croatia, who have a diagnosis of light or moderate intellectual disability, were included in the research. Analysis of responses showed that most participants had experienced psychological, physical and financial abuse. The most frequent perpetrators of abuse were identified by participants as friends, acquaintances and volunteer carers. Typical sites for the experience of abuse were school, social clubs/support institutions, the street and the urban environment. Most participants seek assistance and support in cases of abuse through discussion with their loved ones, mostly their parents and friends. In addition to such informal relationships, some participants mentioned the importance of formal forms of support.

Differences in HIV knowledge and sexual practices of learners with intellectual disabilities and non-disabled learners in Nigeria

INTRODUCTION

Individuals with intellectual disabilities are rarely targeted by the current human immunodeficiency virus (HIV) response, thereby reducing their access to HIV information and services. Currently, little is known about the HIV knowledge and sexual practices of young Nigerians with intellectual disabilities. Thus, this study sought to compare the HIV knowledge and sexual practices of learners with mild/moderate intellectual disabilities and non-disabled learners (NDL) in Nigeria. Findings could help in the development of HIV interventions that are accessible to Nigerian learners with intellectual impairments.

METHODS

This cross-sectional, comparative study utilized a survey to investigate HIV knowledge and sexual practices among learners with mild/moderate intellectual disabilities and NDL in Nigeria. Learners with mild/moderate intellectual disabilities (n=300) and NDL (n=300) within the age range of 12 to 19 years drawn from schools across Oyo State, Nigeria, completed a structured questionnaire to assess their knowledge of HIV transmission and sexual practices.

RESULTS

Significantly more learners with mild/moderate intellectual disabilities (62.2%) than NDL 48 (37.8%) reported having sexual experience (p=0.002). Of the sexually experienced female learners with mild/moderate intellectual disabilities, 28 (68.3%) reported history of rape compared with 9 (2.9%) of female NDL (p=0.053). Intellectual impairment was significantly associated with lower HIV transmission knowledge scores (p<0.001). Learners with mild/moderate intellectual disabilities were less likely than NDL (p<0.001) to have heard about HIV from most of the common sources of HIV information. In addition, when compared with non-disabled learners, learners with mild/moderate intellectual disabilities were significantly more likely to have reported inconsistent condom use with boyfriends/girlfriends (p<0.001), with casual sexual partners (p<0.001) and non-use of condom during last sexual activity (p<0.001).

CONCLUSIONS

Findings suggest that adolescents with intellectual impairments are at higher risk of HIV infection than their non-disabled peers. This gap could be addressed through interventions that target Nigerians with intellectual impairments with accessible HIV information and services.

Self-Defense Among Women With Disabilities

Women with disabilities are frequent victims of domestic violence, yet scant research has examined self-protective mechanisms that could mitigate this abuse. This article reviews prevalence and types of intimate partner violence against women with disabilities and explores the factors that leave this population at higher risk for abuse than nondisabled women. Barriers to self-protection against domestic violence for women with diverse disabilities are highlighted and the use of nonfatal force as self-defense is explored. A case example and considerations for enhancing self-protection strategies for women with disabilities experiencing intimate partner violence are provided.

Children with disabilities in the child protective services system: an analog study of investigation and case management

OBJECTIVE

The study used a series of vignettes to investigate how the presence of three disabilities (cerebral palsy, intellectual disabilities, emotional/behavioral disabilities) affects the processes and outcomes of child abuse investigations at two levels of child injury severity (moderate, severe).

METHOD

Seventy-five CPS case workers completed study surveys and answered questions in response to a series of eight vignettes.

RESULTS

This study revealed differences in the responses of CPS case workers when the alleged victim of physical abuse had a disability. Children with disabilities were more likely than children without disabilities to be seen as having characteristics that contributed to their abuse. Most CPS workers felt at least some empathy with abusive parents; empathy was highest when the children had emotional/behavioral disabilities. Services recommended for families of children with disabilities were more likely to be child-focused. Parent-focused services, such as individual counseling and adult anger management, were more likely to be recommended for families of children without disabilities. In general, differences among disability groups and between cases involving children with and without disabilities were more pronounced when the children's injuries were less severe. Even with more severe injuries, such as a concussion or broken bones, the CPS workers still responded differently depending on the disability status of the child victims.

CONCLUSIONS

Recommendations are made concerning the utilization of investigation teams that include disability specialists and the need for further disability-related training for CPS case workers.

PRACTICE IMPLICATIONS

There is a strong need for training related to disability, with an emphasis on attitudes as well as knowledge and skills. The training should include examples of healthy family functioning and positive aspects of parenting a child with a disability to counteract the prevailing perception of disability as a cause of chronic stress and dysfunction; identification of broader ecological contexts in which these families live, including social response to disability and the disability-related service system and; strategies for disentangling the signs of abuse from characteristics of the disability. Interdisciplinary teams should include members from disability-related fields to share expertise and increase communication between systems.

Prevalence of maltreatment of people with intellectual disabilities: A review of recently published research

Maltreatment can have a profound adverse effect on the health of individuals with intellectual disabilities (ID). People with ID may also be more likely to experience maltreatment than other groups. Historically, data on prevalence of maltreatment among people with ID have been sparse and methodologically weak but have suggested that the scope of the problem is considerable. Studies published between 1995 and 2005 were reviewed to determine estimated maltreatment prevalence among people with ID based on recent literature. Prevalence estimates for people with ID were compared to estimates for people with no disabilities and people with other types of disabilities. Only five studies provided maltreatment prevalence estimates for people with ID. The limited data suggest that maltreatment is more prevalent for people with ID than for people with no disabilities and may be higher for people with ID than for people with certain other disabilities. Most of the available research is still based on convenience samples. More population-level data are needed to provide reliable estimates of the prevalence of this important health problem.

¿Qué se puede hacer para prevenir la violencia y el maltrato de los niños con discapacidades?

Children with physical, psychological and sensorial disabilities are known to be more vulnerable to violence and maltreatment, or to be at a greater risk of these forms of abuse. Violence and maltreatment of children with disabilities is part of the general problem of child maltreatment, which is still under-researched and little known as a whole; prevention, in particular, has received little attention. Preventing violence and maltreatment against children with disabilities means preventing physical pain, emotional suffering, difficulties in integration and sequelae additional to those already experienced by children due to their disability, in addition to avoiding great expense to the community. This article presents a review of the literature published in the last 10 years on the various primary and secondary prevention strategies that have taken place in developed countries, with the aim of bringing the subject to public attention, especially that of health professionals, and of serving as a basis for the planning of future research lines and prevention strategies.