Abstract
BACKGROUND AND AIMS: Adolescents with disabilities are often perceived as sexually inactive and thus overlooked in sexual and reproductive health (SRH) services, particularly in low-resource settings like Ethiopia. Despite having the same SRH needs as their non-disabled peers, they face significant marginalization. This study aimed to assess SRH service utilization among adolescents with disabilities in Bahir Dar City, Northwest Ethiopia, and identify key factors influencing access. METHODS: A community-based cross-sectional survey was conducted among 371 adolescents with disabilities selected through systematic random sampling. Data were collected via a pre-tested structured questionnaire using Epicollect5 and analyzed using SPSS version 27. Binary logistic regression, both bivariable and multivariable, was used to determine factors associated with SRH service use. Statistical significance was set at p < 0.05. RESULTS: The overall utilization of sexual and reproductive health (SRH) services among youth with disabilities was 29.4% (95%CI: 25.3-33.5). Youths who had acquired their disability at an early age of childhood [AOR = 2.87, 95%CI: 1.46-5.62], having physical impairment [AOR = 4.14, 95%CI: 2.12-8.10], good knowledge [AOR = 2.94, 95% CI: 1.40-6.15], being one's own source of income [AOR = 0.180, 95%CI: 0.05-0.31], unfavorable attitude [AOR = 0.48, 95% CI: 0.22-1.06], and lack of respectful services [AOR = 0.12, 95%CI: 0.05-0.31] were found to be significantly associated with SRH service use. CONCLUSION: SRH service utilization among youth with disabilities remains low and far below national and global targets. Factors such as impairment type, age at disability onset, income source, knowledge, and attitude significantly influenced service use. The findings highlight the need to enhance SRH awareness, foster positive attitudes, promote economic empowerment, and ensure inclusive, respectful healthcare delivery for young people with disabilities. Targeted interventions are crucial to bridge the accessibility gap and uphold the SRH rights of this underserved group.