title: A situational analysis of sexual and reproductive health issues in physically challenged people, attending a tertiary care hospital in New Delhi.
abstract: OBJECTIVE
  Physically challenged people constitute the most stigmatized sections of society, and are excluded from outreach programs, besides being considered sexually inactive. They have unaddressed sexual and reproductive healthcare (SRH) issues, predisposing them to sexual abuse and sexually transmitted infections (STIs). The huge paucity of data in this field prompted us to undertake this study.
  
  
  METHODS
  A cross-sectional survey was conducted on 100 people with more than 40% of permanent disability, attending various out/inpatient facilities of a tertiary care hospital in New Delhi, India. A structured, pretested questionnaire was used to assess SRH issues. Samples were collected from consenting individuals for diagnosis of various STIs, wherever relevant. Statistical analysis was done using Pearson's Chi-square test, considering significant atP<0.05.
  
  
  RESULTS
  Most people were in the age group of 15-30 years. Limbs were most commonly affected, and the use of assistive devices was statistically related to income levels (P= 0.045), 43% was married and 41% had children. Contraceptive usage was 33%, with a significant association (P= 0.03) with education levels. Issues related to sexual health included conditions ranging from nerve sensation loss in genitalia to fertility and gynecological issues, only 10% had received sexual counseling during rehabilitation. There were several misconceptions prevalent regarding HIV and STIs; 35% of the samples tested positive for chlamydia IgG.
  
  
  CONCLUSIONS
  This is a pioneer study on a grossly neglected issue in India. There is a dire need to overcome hurdles and address the SRH issues of physically challenged people to achieve the universal WHO goal of "Health for All."
authors.affiliation: Apex Regional STD Teaching, Training and Research Centre, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
authors.forename: Utkarsha
authors.initials: U
authors.lastname: Agarwal
authors.affiliation: Apex Regional STD Teaching, Training and Research Centre, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
authors.forename: Sumathi
authors.initials: S
authors.lastname: Muralidhar
keywords: Counseling; disability; disabled; reproductive health; sexual health