Sexually Transmitted Infections (STIs) & People with Intellectual and Developmental Disabilities (ID/DD)
A clear, inclusive guide for caregivers, health-professionals, and support networks.
Why Sexual Health is important
Sexual health—including the prevention and management of STIs—is rarely discussed in the context of ID/DD, yet people with ID/DD have the same rights to sexual expression, relationships, safety, and health as anyone else. As one review states, “people with intellectual disabilities face various personal and socio-environmental barriers in their sexual lives,” (BioMed Central).
Ignoring STI-related issues in the ID/DD population risks reinforcement of stigma, neglect of health needs, and missed opportunities for prevention and support.
What the research tells us
Risk, prevalence & testing
A large U.S. study compared privately insured adults with ID/DD (n ≈ 25,000) versus matched peers without ID/DD. It found that those with ID/DD were significantly less likely to have a documented STI diagnosis. The authors speculate this may reflect earlier supervision, fewer sexual partners, or under-detection in healthcare settings (PubMed).
Another study found adolescents and young adults with disabilities had lower rates of STI screening (e.g., for chlamydia/gonorrhea) compared with peers without disabilities (JPAG Online).
Qualitative reviews reveal people with intellectual disability often have limited knowledge of STIs and how they are transmitted (Oxford Research Encyclopedia).
Barriers and contributing factors
Limited sexual health education tailored to ID/DD means many individuals don’t receive accessible information on STIs, safe sex practices, or how to access services (BioMed Central).
Communication differences, limited literacy, and cognitive processing challenges may reduce ability to negotiate safe sex, recognize symptoms, or seek testing (BioMed Central).
People with ID/DD are more vulnerable to sexual abuse or coercion, which increases risk of STI exposure (BioMed Central).
Healthcare settings may lack inclusive protocols (e.g., for education, screening, accessible consent), leading to under-testing and under-diagnosis (AOTA Research).
What to do: Practical guidance
For caregivers, support staff, and families
Start with accessible education. Use plain-language and visual materials about STIs: how they are transmitted, how to prevent them (condoms, limiting partners, testing), what symptoms to look for, and how to ask for help.
Encourage and enable testing. Support the person to attend sexual-health services. Explain the process: “The nurse will ask some questions and take a swab or urine test, just like a check up.” Help with booking, transport, accompaniment.
Support consent and safe relationships. Help the individual understand consent and boundaries: who can touch them in which way, how to say “no”, how to tell a trusted person if something makes them uncomfortable.
Offer routine discussion and normalization. Make conversations about sexual health part of regular support planning—just as you would for hygiene, nutrition, or mental-health. Avoid treating sex as taboo.
Adapt for communication needs. If someone uses AAC (augmentative and alternative communication) or visual schedules, include sexual-health/relationship education and STI-screening in their plan.
For health-care / sexual-health professionals
Ensure accessibility. Clinics should offer easy-read forms, extended appointment times, visuals/pictograms, and communication supports for people with ID/DD.
Proactively offer screening. Don’t assume low risk; ask about sexual activity and exposure in a respectful, non-judgmental way. Recognize that people with ID/DD may have fewer opportunities to advocate for themselves.
Collaborate with support networks. With the person’s consent, involve caregiver/support staff in making sure the person understands the process, attends appointments, and follows up.
Use tailored educational materials. Standard brochures may be too complex; adapt language, use visuals, role-play scenarios if needed.
Track outcomes and ensure follow-up. If a patient with ID/DD is tested, ensure results and treatments are presented in understandable form and support is provided for any follow-up care.
Addressing specific myths and realities
Myth: People with ID/DD are not sexually active, so STI risk is negligible.
Reality: While some individuals may have less partner activity or supervision, data show many people with ID/DD do engage in sexual relationships; and because of additional vulnerabilities (e.g., coercion, lack of negotiation skills), risk still exists (BioMed Central).Myth: Screening is always done as in the general population.
Reality: Evidence shows lower rates of STI screening among people with disabilities, including ID/DD (JPAG Online).Myth: If no diagnosis is found, risk is zero.
Reality: Lower diagnosed rates may reflect under-testing or under-reporting rather than true absence of risk. Providers and support networks must stay vigilant.
Policy and organizational considerations
Service and support agencies should integrate sexual-health curricula inclusive of STI prevention for people with ID/DD. The systematic review of women with intellectual disability highlighted the need for school-based sexuality education tailored to understanding, including STI topics (BioMed Central).
Health systems should implement monitoring and quality-improvement efforts on screening rates, education delivery, and outcomes for people with ID/DD.
Advocacy efforts should address accessibility of sexual-health services (physical access, communication access, decision-making support) for people with ID/DD.
Final thoughts
People with ID/DD absolutely deserve sexual-health care that is accessible, respectful, and proactive — including STI education, prevention, testing, and treatment. While research suggests lower documented STI rates for people with ID/DD, this should not breed complacency. Rather it should drive more inclusive practices, better communication, and systematic support. With informed caregivers, responsive health-care systems, and accessible education, individuals with ID/DD can enjoy safe, healthy relationships and sexual lives.