(024) Let's [Assess How We] Talk About Sex! Results from a Single-Institution Pilot of an Original Survey that Assesses Medical Student Comfort, Knowledge Gaps, and Barriers to Speaking to Patients with Disabilities About Sexuality & Sexual Health
Authors: Murthy A , Hickey E , Pak JJ , Ahern T 
Published: February 2024

Abstract

Introduction
Many persons with disabilities (PwDs) lack knowledge and opportunity to develop a healthy sexual identity. Sexual education in adulthood is often inaccessible and lacks resources on dating, intimacy, and sexuality. PwDs are consistently reported to be at greater risk of experiencing sexual violence and trauma. This violence is a result of many structural factors that include: misinformation and bias against persons with disabilities, lack of knowledge about healthy intimate relationships, lack of caregiver support, and communication barriers. Many PwDs interact with medical spaces, making the clinical encounter a unique opportunity to help address these gaps. In order to achieve this, providers must be prepared to comprehensively address topics at the intersection of disability and sexuality.

Objective
Authors created an original needs assessment survey to identify gaps in knowledge, trends in attitudes, and comfort in working with PwDs among healthcare professionals.

Methods
Questions were adopted from a published survey created by researchers at another university to encompass topics specific to the intersection of disability, sexuality, and healthcare. Two self-advocates and an organizer from a local Disabled Self-Advocacy group provided feedback on survey themes and accessibility. It includes demographic, 5-point Likert scale, open-ended and multiple choice questions and takes 7 minutes to complete. It was shared via REDCap to M1 and M2 students at an urban teaching hospital during the 2021-2022 school year. 70 students responded and none reported having specific training on caring for patients with disabilities prior to taking the survey.

Results
90% of students agreed that sexuality and sexual health are important aspects of a total person and crucial to explore during clinical encounters. However, 83% of students reported NOT having sufficient disability-informed, gender inclusive, comprehensive sexual health and sexuality training; 57% reported not feeling comfortable discussing sexual health with PwDs; 49% reported not feeling prepared to support PwDs when they disclose details of sexual abuse or domestic violence. Students are eager to fill these gaps, with 89% reporting interest in learning how to speak to patients with disabilities about sexual health and sexuality.

Conclusions
The following are recommendations for medical schools to support their students in providing comprehensive sexual health and sexuality care for patients with and without disabilities: 1) Provide gender and sexual orientation inclusive, disability informed training throughout medical school 2) Work directly with self-advocates with personal and/or professional experience in the realm of disability, sexuality and healthcare to develop trainings 3) Address the following topics within trainings: · Sexual History · Sexual Health · Sexual Needs · Masturbation/Self-Pleasure · Family Planning · Intimacy Needs · Healthy Relationships · Gender & Sexual Orientation · Disruptive/Appropriate Sexual Behavior · Consent · Sexual/Domestic Violence · Pregnancy · How to speak to patients with developmental disabilities · How to speak to patients who do not use spoken language Using these results and a disability-informed sexual health curricula that one of the authors was trained in, we created 3 versions of disability and sexuality workshops. We offer these workshops to preclinical students at the medical school surveyed at least once a semester.

Disclosure
No.