Disability is associated with sexually transmitted infection: Severity and female sex are important risk factors

Abstract

It has been suggested that disabled people may experience higher rates of sexually transmitted infections (STI) due to health inequities and sexual education gaps. Using a pan-Canadian health survey, we sought to explore the association with disability and STI. Using the public use microdata file for the 2013–2014 cycles of the Canadian Community Health Survey (Statistics Canada), the association between disability and STI was explored. Modelling included adjustment for age, ethnicity, geography, living arrangement, educational status, and marital status. Results were stratified for females and males, disability severity, and type. Both females (odds ratio [OR] 1.54, 95% confidence intervals [CI] 1.27–1.86) and males (OR 1.29, 95% CI 1.03–1.62) with any impairments were more likely to report a diagnosis of STI. A graduated effect was seen, with the odds increasing as the severity of disability increased. Females with severe visual impairment (OR 6.88, 95% CI 2.13–22.17) had the highest association with STI. Associations were most consistently seen in females, suggesting sex differences in risk for disabled people. Given that Canadians living with disabilities are more likely to report having been diagnosed with a STI, future work is needed to further understand the causes. In the meantime, these findings signal a need for clinicians to ensure this group is engaged with STI screening, as well as the greater need for improved strategies to address the sexual health needs of those living with a disability of all severities and types.