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These activities cannot be strictly considered prostitution. The first interesting finding is that the vast majority Prostitutes LAquila trained sexual assistants exhibit behaviours resembling prostitution less frequently than untrained sexual assistants do. The study population was composed Prostitutes LAquila participants males and females who claimed to be 18 years of age or over and defined themselves as sexual assistants.

Hence, the sexual assistant is learned about disability and the modes of connecting with people affected by disabilities, aiming at their sexual needs through caresses and massages and ultimately masturbatory activities. However, people affected by disabilities wishing sexual intercourse require the help of local prostitutes, who are for Prostitutes LAquila most part untrained with respect to the special needs of men and women with disabilities.

Sexual assistants work in many European countries, such as Denmark, Germany, Netherlands, and Spain, where they have a proper legal status. In other countries, such as France, sexual assistants do not yet have a proper legal status, Prostitutes LAquila in Prostitutes LAquila sexual assistants have a status similar to Prostitutes LAquila of prostitutes. However, although untrained prostitutes may receive clients with disabilities, sexual assistants are more highly regarded by parents of people affected by disabilities, who believe that Prostitutes LAquila affected by disabilities need more time Prostitutes LAquila contact than able-bodied people.

Sexual assistants are more similar to a group of individuals who have an atypical sexual attraction for disability. Recently, we described a population with a fetishistic attraction to disability.

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Thus, the entire field of sexual assistance is still largely unknown and a matter of debate. The primary aim of this study was to verify whether specific aspects of prostitution were equally present in groups of professionally trained and untrained subjects who claimed to work as sexual assistants. The secondary aims were i to investigate whether sexual assistants had characteristics suggestive of an atypical sexual interest, and ii to determine if this sexual interest was more recurring in the group of subjects professionally trained or in the group spontaneously undertaking this job.

This internet-based survey was developed in the period between June and March Prostitutes LAquila the covert Prostitutes LAquila of the study population, it was Prostitutes LAquila to select a representative sample of sexual assistants. These difficulties are mainly related to the evidence that i the population of sexual assistants is virtually unknown and variously estimated; ii sexual assistance Prostitutes LAquila consist Prostitutes LAquila different activities; iii the population is likely to include professionally trained as well as opportunistic or untrained workers who may provide their services spontaneously for a fee or gift but may not be explicitly involved with commercial or professional sexual assistance; and iv while sexual assistants in commercial premises are likely to be accessible, opportunistic or untrained sexual assistants are Prostitutes LAquila difficult to contact.

Thus, our study population was selected via a cross-sectional convenience sample non probability sampling using snowballing as the main method of Prostitutes LAquila, as suggested for studies with study populations like the one analysed here [5]. The study Prostitutes LAquila was composed of participants males and females who claimed to be 18 years of age Prostitutes LAquila over and defined themselves as sexual assistants.

Another inclusion criterion observed while searching for the sample was the ability to speak English, German, or Italian. Subjects were initially contacted on websites specifically dedicated to sexual assistants and prostitutes Appendix S1.

All known sources were used to individuate sexual assistants, and recruitment strategies included collaboration with Prostitutes LAquila individuals and associations involved in the training of sexual assistants. Individuals who initially agreed to participate in the survey were then contacted by personal email. Participants received a detailed description of the study aims and design and of the level of commitment to which they would be agreeing.

However, we did our best to include the largest number of internet data on sexual assistance possible.

The participants were unpaid and willingly took part in Prostitutes LAquila research. This study was performed Prostitutes LAquila accordance with the Declaration of Helsinki and the European Union Guidelines on Good Clinical Practice, and was approved by the local ethical committee. Written informed consent Prostitutes LAquila obtained from each participant. By sexual assistance we mean one or more of Prostitutes LAquila activities: sexual Prostitutes LAquila, oral sex, massage therapy including erotic massage, masturbatory acts, and discussion of sexuality, contraception, and the appropriate use of sex toys.

Intellectual disability can be considered as a condition for which the intelligence level is below-average and the skills necessary for day-to-day living are inadequate.

Part of this semi-structured questionnaire was previously Prostitutes LAquila to study a population of subjects who are attracted by disability and called devotees [8]. In the present study, additional aspects were investigated in order to verify the existence of specific elements characterising Prostitutes LAquila work and atypical sexual interest in a population composed of trained and untrained sexual assistants.

Finally, we used the Kinsey Scale [10]a Prostitutes LAquila used measure in the attempt to describe sexual orientation, with scores ranging from 0 exclusively heterosexual to X nonsexual. Continuous variables were condensed by means and standard deviation SD. Binary variables were condensed as absolute or relative frequencies. In order to reduce treatment selection bias and determine treatment effects, a matched propensity analysis was performed.

Multivariate logistic regression was used to calculate the predicted probability of the dependent variables as well as the propensity score for each observation in the data set. In particular, the use of propensity analysis in observational, nonrandomized studies, permits to balance the groups in order to reduce the effects of confounding. The dependent variables included in the multivariate analysis are listed in Table 1. The SPSS version More than half the participants All subjects belonging to this group were considered professionally trained.

The remaining subjects This last group did not receive professional training to practice sexual assistance. Prostitutes LAquila half the sexual assistants For the comparative analysis between trained and untrained sexual assistants regarding the presence of characteristics suggestive of prostitution and atypical sexual Prostitutes LAquila, a propensity score analysis was performed.

The population analysed consisted of Prostitutes LAquila and their completed questionnaires. After propensity analysis selection, the number of subjects included in the comparative analysis consisted of participants and their questionnaires. This number was achieved by excluding 32 subjects who did not present overlapping propensity score values.

The final sample of sexual assistants was Prostitutes LAquila of 80 trained Prostitutes LAquila 40 untrained sexual assistants with mean ages of Other demographics are reported in Table 1. While The percentage of participants who engaged Prostitutes LAquila such activities during sexual assistance was much smaller Sexual fantasies about or overt sexual attraction to disabled people was reported by On the contrary, This could suggest that these subjects may be affected by a paraphilic disorder.

We further investigated what the sexual assistants considered most attractive in people affected by disabilities. Sexual assistance has aspects that could resemble prostitution and others suggesting that sexual assistants may be similar to Prostitutes LAquila with a specific sexual interest in disability devotees [8].

This study represents the first attempt to investigate these two relationships in a population of subjects who define themselves as sexual assistants. In particular, we investigated whether rigorous selection and training by specialised organisations may reduce the risk of training subjects with an atypical sexual interest or behaviours resembling prostitution.

The first interesting finding is that the vast majority of trained sexual assistants exhibit behaviours resembling Prostitutes LAquila less Prostitutes LAquila than untrained sexual assistants do. Lobbyists and associations dedicated to protecting people with disabilities are strongly committed to the idea that sexual assistance is very different from prostitution, and the professional figures involved in this activity must have a Prostitutes LAquila sense of altruism and a great open-mindedness.

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We found that both trained and untrained Prostitutes LAquila assistants provide their services under remunerative or commercial conditions. However, the main difference between these two groups lies in the activities carried out.

The trained group mainly provides massage therapy, including erotic massage, and discussion about sexuality, contraception, and the appropriate use of sex toys. These activities cannot be strictly considered prostitution. A minority of trained assistants refer to being engaged in masturbatory activities or sexual intercourse that, on the contrary, may be considered activities more typical of prostitution.

Prostitutes LAquila, these activities are mainly provided outside of their job as sexual assistants. In contrast, untrained sexual assistants provide sexual Prostitutes LAquila such as oral sex, masturbation, or sexual intercourse much more frequently. These findings seem to confirm that when sexual assistants are trained and carefully selected by specialised organisations, they provide services and activities that do not resemble prostitution.

It should be clarified that when sexual assistance has characteristics similar to prostitution, this is not necessarily negative. In fact, an ethical evaluation of the sexual choices of the sexual assistants is beyond the scope of our study.

Furthermore, it is well known Prostitutes LAquila people affected by disabilities find it much more difficult to satisfy their normal sexual Prostitutes LAquila than other individuals do. For the large majority of people affected by Prostitutes LAquila, sexual assistance represents the unique possibility to explore their sexuality in a safeguarded setting.

Another interesting finding of our study is the identification of subjects with an atypical sexual interest in disability [9] within the sexual assistant groups. These subjects Prostitutes LAquila characterised by the presence of sexual fantasies about or sexual attraction to disabled people. These behavioural aspects were found especially in the group of untrained sexual Prostitutes LAquila, who also report experiencing distress over their sexual interest more often than trained subjects do.

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This information may suggest that untrained sexual assistants Prostitutes LAquila more sexual attraction to disability. The findings Prostitutes LAquila the existence of subjects with an atypical sexual interest among sexual assistants may have significant consequences from a practical point of view.

It is well known that people affected Prostitutes LAquila physical, and still more by mental disabilities, are Prostitutes LAquila vulnerable to sexual violence [12][13]. This risk is often due to a lack of employment, strained personal finances, or the desire for a relationship and social connections [13].

However, consideration needs to be given to the potential risk factors of sexual violence that personnel involved in sexual assistance may commit against disabled people. These attractions might give rise, in some circumstances, to the abuse of people affected by mental disabilities.

This study presents some limitations.

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However, in certain research fields, such as sexuality [8][14]studies refer to some advantages of Prostitutes LAquila internet that make Prostitutes LAquila easier [15]. In particular, the anonymity and the elimination of the uneasiness caused by face-to-face interviews can encourage more honest Prostitutes LAquila [16][17].

In addition, the internet may provide a unique opportunity to achieve geographical and cultural diversity in samples [17]. Secondly, the subjects studied here were recruited from online forums and chat groups Prostitutes LAquila to sexual assistance, from associations organising educational training for sexual assistants, and from associations for prostitutes. For this reason, these data may be not representative of the whole population of sexual assistants.

However, we did our best to include the largest number of internet data on sexual assistance possible. Thirdly, we focused especially on female sexual assistants for heterosexual people affected by disabilities. Other subsets composed of male sexual assistants for homosexual males or heterosexuals belonging to different associations of sexual assistants and prostitutes from other countries not considered in this study Prostitutes LAquila have to be explored, in order to make more representative the sample.

However, the main difference between these two groups lies in the activities carried out. Prostitutes LAquila trained group mainly provides massage therapy, including erotic massage, and discussion about sexuality, contraception, and the appropriate use of sex toys. These activities cannot be strictly considered prostitution.

A minority of trained assistants refer to being engaged in masturbatory activities or sexual Prostitutes LAquila that, on the contrary, may be considered activities more typical of prostitution. However, these activities are mainly provided outside of their job as sexual assistants. In contrast, untrained sexual assistants provide sexual services such as oral sex, masturbation, or sexual intercourse much more frequently.

Prostitutes LAquila findings seem Prostitutes LAquila confirm that when sexual assistants are trained and carefully selected by specialised organisations, they provide services and activities that do not resemble prostitution. It should be clarified that when sexual assistance has characteristics similar to prostitution, this is not necessarily negative. Prostitutes LAquila fact, an ethical evaluation of the sexual choices of the sexual assistants is beyond the scope Prostitutes LAquila our study.

Materials and Methods The study population consisted of subjects defining themselves as sexual assistants.

Furthermore, it is well known that people affected by disabilities find it much more difficult to satisfy their normal sexual interest than other individuals do.

For the large majority of people affected by disabilities, Prostitutes LAquila assistance represents the unique possibility to explore their sexuality in a safeguarded setting. Another interesting finding of our study is the identification of subjects with an atypical sexual interest in disability [9] within the sexual assistant groups. These subjects Prostitutes LAquila characterised by the presence of sexual fantasies about or sexual attraction to disabled Prostitutes LAquila.

These behavioural aspects were found especially in the group of untrained sexual assistants, who also report experiencing distress over their sexual interest more often than trained subjects do.

This information may suggest that untrained sexual assistants Prostitutes LAquila more sexual attraction to disability. The findings of the existence of Prostitutes LAquila with an atypical sexual interest among Prostitutes LAquila assistants may have significant consequences from a practical point of view. It is well known that people affected by physical, and still more by mental disabilities, are particularly vulnerable to sexual violence [12][13].

This risk is often due to a lack of employment, strained personal finances, or the desire for a relationship and social connections [13]. However, consideration needs to be given to the potential risk factors of sexual violence that personnel involved in sexual assistance may commit against disabled people.

These attractions might give rise, in some Prostitutes LAquila, to the abuse of people affected by mental disabilities. This study presents some limitations.

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However, in certain research fields, such as sexuality [8][14]studies refer to some advantages of the internet that make research easier [15]. In particular, the anonymity and the Prostitutes LAquila of the uneasiness caused by face-to-face interviews can encourage more honest participation [16][17].

In addition, the internet may provide a unique opportunity to achieve geographical and cultural diversity in samples [17]. Secondly, the subjects studied here were recruited from online forums and chat groups dedicated to sexual assistance, from associations organising educational training for sexual assistants, and from associations for prostitutes. For Prostitutes LAquila reason, these data may be not representative of the whole population of sexual assistants.

However, we did our best to include the largest number of internet data on sexual assistance possible. Thirdly, we focused especially on female sexual assistants for heterosexual people affected by disabilities. Other subsets composed of male sexual assistants for homosexual males or heterosexuals belonging to different associations of sexual Prostitutes LAquila and prostitutes from other countries not considered in this study will have to be explored, in order to make more representative the sample.

However, considering that for a number of reasons both physical and intellectual disabilities affect males much Prostitutes LAquila than females [18] — [20]and that, irrespective of the sociocultural aspects, female sex workers are much more common than their male counterparts, we speculate that our experimental setting reflects the largest part of this phenomenon.

Finally, using a non standardised questionnaire might expose us to criticisms, Prostitutes LAquila if this methodology represents the most effective methodology to collect psychometric and demographic data on this new phenomenon. Future perspectives will require a clear understanding of the phenomenon of sexual assistance and a standardised methodology in order to continue Prostitutes LAquila people affected by disabilities with the opportunity to explore their sexuality while ensuring their psychological and physical Prostitutes LAquila.

Sexual assistance provides Prostitutes LAquila way for people affected by disabilities to attain the right to explore their sexuality in a safeguarded setting. This goal is more effectively achieved if sexual assistants are trained and carefully selected by specialised organisations.

Performed the experiments: EL DG. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field. Abstract Introduction Sexual assistance may have some aspects that resemble prostitution and others Prostitutes LAquila might lead one to think of sexual assistants as similar to a group of subjects whose sexual object is disability devotees.

Materials and Methods The study population consisted of subjects defining themselves as sexual assistants. Results The study group was composed of 80 trained and 40 untrained sexual assistants, with mean ages of Conclusions Sexual assistance represents a way through which people affected by disabilities may attain the right to explore their sexuality in a safe setting.

Funding: These authors have no support or funding to Prostitutes LAquila. Introduction The lives of persons affected by disabilities, and especially the lives of those affected Prostitutes LAquila intellectual disabilities, are often characterised by the lack of a job, meaningful activities, and close relationships [1][2]. Thus, the entire field of sexual assistance is still largely unknown and Prostitutes LAquila matter of debate.

Aims The primary aim of this study was to verify whether specific aspects of prostitution were equally present in groups of professionally trained and untrained subjects who claimed to work as sexual assistants. Materials and Methods Subjects Prostitutes LAquila internet-based Prostitutes LAquila was developed in the period between June and March Statistical Methods Continuous variables were condensed by means and standard deviation SD.

Download: PPT. Table 1.

The table shows the clinical variables between groups according to propensity score matching. Figure 1. Table 2.

The table shows the questions investigating characteristics suggestive of prostitution. An Atypical Sexual Interest is more Prevalent among Untrained Sexual Assistants Sexual fantasies about or overt sexual attraction to disabled people was reported by Discussion Sexual assistance Prostitutes LAquila aspects that could resemble prostitution and others suggesting that sexual assistants may be similar to subjects with Prostitutes LAquila specific sexual interest in disability devotees [8].

Conclusions Sexual assistance provides a way for people affected by disabilities Prostitutes LAquila attain the right to explore their sexuality in a safeguarded setting. Supporting Information. Appendix S1. Websites dedicated to sexual assistance and prostitution. References 1. Hall E Spaces of social inclusion and belonging for people with intellectual disabilities. J Intellect Disabil Res 54 Suppl — View Article Google Scholar 2.

Bigby C Known well by no-one: trends Prostitutes LAquila the informal social networks of middle-aged and older people Prostitutes LAquila intellectual disability five years after moving to the community.

J Intellect Dev Disabil — View Article Google Scholar 3. Rembis MA Beyond the binary: rethinking the social model of disabled Prostitutes LAquila. Sex Disabil 51— View Article Google Scholar 4. J Policy Pract Intellect Disabil 6: — View Article Google Scholar 5. Harcourt C, Donovan B The many faces of sex work.

Sex Transm Infect — View Article Google Scholar 7. Blissbomb L Sex work for the soul: negotiating stigma as a feminist activist Prostitutes LAquila closeted sex worker. Demistifying Sex Work and Sex Workers 8: — View Article Google Scholar 8.

View Article Google Scholar 9. Prostitutes LAquila Psychiatry Rep View Article Google Scholar Philadelphia, PA: W. Di Nucci EJ Sexual rights and disability.

J Med Ethics — J Intellect Disabil — Kuosmanen J, Starke M Women and men with intellectual disabilities who sell or trade sex: voices from the professionals. Prostitutes LAquila Soc Work Disabil Rehabil — Int J Impot Res —

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Other subsets composed of male sexual assistants for homosexual males or heterosexuals belonging to different associations of sexual assistants and prostitutes from other countries not considered in this study will have to be explored, in order to make more representative the sample. A minority of trained assistants refer to being engaged in masturbatory activities or sexual intercourse that, on the contrary, may be considered activities more typical of prostitution. The lives of persons affected by disabilities, and especially the lives of those affected by intellectual disabilities, are often characterised by the lack of a job, meaningful activities, and close relationships [1] , [2].