Supporting Someone with ID/DD with PrEP & STI Screening
Sexual health is an important — but often overlooked — part of care for people with intellectual and/or developmental disabilities (ID/DD). For HIV and STI prevention, tools like PrEP and regular STI screening can make a meaningful difference. But many with ID/DD face lower rates of STI screening, limited access to information, and additional barriers to care. (PubMed)
Here’s why PrEP and STI screening matter — and how caregivers, families, and support staff can help make them accessible and affirming.
Why PrEP & STI Screening Matter
PrEP dramatically reduces HIV risk
PrEP is a proven, effective HIV-prevention strategy. When taken consistently, it can reduce the risk of HIV from sex by about 99%. It can also reduce the risk for people who inject drugs. (HIVinfo)
PrEP comes in multiple forms (daily pills or regular injections), giving flexibility depending on the individual’s needs. (HIVinfo)
STI screening identifies infections that often go unnoticed — and can signal HIV risk
Frequent screening for STIs (like gonorrhea, chlamydia, syphilis) is a key part of sexual-health care. When STIs go undiagnosed and untreated, they can increase both health complications and risk of HIV transmission. (CDC)
For people on PrEP, STI screening is part of ongoing care — offering regular opportunity to detect and treat infections early. (CDC)
People with disabilities — including ID/DD — are less likely to receive regular STI screening
Data show that adolescents and young adults with disabilities (including intellectual disabilities) get STI screening less frequently than their peers without disabilities. (PubMed)
This disparity suggests a real need for intentional, inclusive outreach and support to ensure sexual health care is accessible to people with ID/DD.
Who Might Especially Benefit from Knowing About PrEP and STI Screening
Here are some groups of people — including those with ID/DD — who may benefit significantly from information and access to PrEP and regular STI screening:
Sexually active individuals with ID/DD who may have limited access to sexual health education or resources.
People with ID/DD who have multiple or changing partners, or whose relationships may include partners with unknown HIV/STI status.
ID/DD individuals who are not consistently able to use or negotiate barrier methods (like condoms), or who face difficulties communicating about safer sex.
Those with a history of an STI (e.g., gonorrhea, chlamydia, syphilis), which increases risk for HIV — a key indication for PrEP. (HIVinfo)
People who inject drugs (including with shared equipment), regardless of disability status — but especially those whose disability may intersect with substance-use risk. (CDC)
Sexually active adolescents or adults (including ID/DD) living in areas with higher HIV prevalence or with limited access to health-care services. (CDC)
Individuals entering or re-entering periods of increased risk (new partner, change in living situation, etc.), for whom PrEP may offer additional protection when needed most. (CDC)
How Caregivers, Support Staff, and Health Professionals Can Help
Use inclusive, accessible communication
Explain PrEP and STI screening in plain, easy-to-understand language. Use visuals, social stories, or other accessible communication tools if helpful.
Normalize the conversation: treat sexual health as part of overall well-being, not something to be avoided or stigmatized.
Offer PrEP as an option — and frame it as part of comprehensive sexual-health care
According to updated guidance, health providers should inform all sexually active patients about PrEP — not only those who volunteer risk factors. (CDC)
For individuals with ID/DD, this means proactively offering information, in a way they can understand, rather than waiting for them to ask.
If PrEP is chosen, ensure supportive structures: regular follow-ups, medication adherence support, and accessibility adjustments (transportation, reminders, communication supports) as needed.
Build in regular STI and HIV screening
Routine STI and HIV testing (before starting PrEP and during follow-up) is critical. (CDC)
For persons with ID/DD, ensure privacy, respect, and dignity during testing — and provide support to understand results, follow-up care, and prevention.
Address barriers proactively
Many people with disabilities face additional obstacles: lack of provider knowledge or comfort, limited accessible sexual-health education, communication challenges, or low health literacy. (LGBTQIA+ Health Education Center)
Advocate for provider training on disability-inclusive sexual health care.
Use community-linked resources (sexual-health clinics, community health organizations) when specialized care is needed.
Support clients/patients in navigating insurance, assistance programs, cost, and follow-up care.
Respect autonomy and consent
As with all people, individuals with ID/DD deserve full respect for their right to make informed decisions about their bodies. Offer information and support — but always prioritize their consent, privacy, and self-determination.
Challenges & Important Considerations
PrEP does not protect against non-HIV STIs — so condom use or other barrier methods remain important when STI prevention is also a goal. (HIVinfo)
Success depends on adherence — missing doses or failing to attend follow-up appointments can reduce PrEP’s effectiveness. (HIVinfo)
People with disabilities may face systemic barriers: lower rates of STI screening, less sexual-health education, social stigma, and lack of accessible clinics. (PubMed)
Sexual-health conversations must be handled with sensitivity, respect, and confidentiality — especially for individuals who may have experienced past trauma or have limited communication options.
The Importance of Sexual Health Equity — and What This Means for ID/DD Communities
Sexual health — including prevention of HIV and STIs — is a critical component of overall health and quality of life for everyone. For people with ID/DD, ensuring access to PrEP and regular STI screening isn’t optional. It’s a matter of equity, dignity, and respect.
By proactively offering information, making care accessible, and respecting autonomy and consent, caregivers, support staff, and health professionals can help close the gap in sexual-health outcomes for people with ID/DD.
If you work in care or advocacy: consider how your practices — education, communication, access, follow-up — could better support sexual health for people with ID/DD. The difference you make may be profound.