Public Opinion on the Sexuality of People with Intellectual Disabilities: A Review of the Literature

The relationship of stereotypes, social distance and sexuality knowledge with attitudes towards sexuality of people with mild intellectual disabilities

BACKGROUND

The present study examines the relationship between stereotypical beliefs about people with intellectual disabilities, desire for social distance, and general knowledge about human sexuality with attitudes towards the sexuality of adults with mild intellectual disabilities.

METHOD

Two hundred fifty participants from staff, family and community samples completed an online set of questionnaires.

RESULTS

Higher agreement with stereotypical beliefs and lower sexual knowledge were associated with less normalising and more paternalistic attitudes towards the sexuality of adults with mild intellectual disabilities. Higher agreement with stereotypical beliefs was also associated with more negative attitudes. On the other hand, willingness to interact with these adults was associated with more normalising and less paternalistic attitudes.

CONCLUSIONS

Interventions that aim to support adults with intellectual disabilities in relation to their sexuality should also address the perceptions of their support network towards them as individuals with disabilities, as well as their knowledge about sexuality.

Attitudes towards the sexuality of adults with intellectual disabilities: Family, staff, community and student perspectives

Background: The sexual expression of adults with intellectual disabilities can be hindered by negative attitudes towards their sexuality. This study aims to examine current attitudes of staff, family, community and students towards the sexuality of adults with intellectual disabilities and how sociodemographic variables may influence these attitudes. Methods: 305 participants completed an online questionnaire, including the ASEXID scale. Results: Scores were highest for the normalising attitude and lowest for the negative attitude, with intermediate scores for the paternalistic attitude. Staff and university students exhibited a more normalising attitude than families and community. Community participants exhibited a more negative attitude than staff and students. Older age was associated with less normalising and more paternalistic attitudes. Being male with a more negative attitude. Discussion: These findings should be taken into account by professionals. Intermediate scores on the paternalistic attitude may mediate difficulties in supporting adults with intellectual disabilities in their sexuality.

Sexual experiences and knowledge of people with moderate intellectual disability

BACKGROUND

This study addresses the sexuality of people with moderate intellectual disabilities (PMID), a topic that has been little studied. Understanding romantic and sexual experiences is highly relevant for reducing stigma and prejudice related to their sexuality. Additionally, comprehending the level of sexual knowledge of PMID contributes to the development of preventive and sexual health education programmes tailored for this group. Our aim is to explore the sexual history (relationships, sexual behaviour, condom use and sexual abuse), sex education received and the level of sexual knowledge of PMID.

METHOD

The total of 142 PMID completed questionnaires about sexual knowledge and experiences, and their support staff provided additional information. Data were analysed using chi-square test (χ2) and descriptive statistical analysis.

RESULTS

Masturbation was the most common sexual behaviour (75.7%), especially among men (χ2 = 5.81, P < 0.05). Sexual intercourse was rare, and only 30.5% reported using condoms. Women reported a higher prevalence of self-reported sexual abuse (27.3% vs. 6% in men). The study also highlighted misconceptions about sexual intercourse risks and contraceptive methods.

CONCLUSION

The results suggest that PMID need sexual education to ensure healthy sexual experiences and prevent risky behaviour.

Challenges in the delivery of sex education for people with intellectual disabilities: A Chinese cultural-contextual analysis

BACKGROUND

Staff members' views can have a significant impact on sexuality issues of people with intellectual disabilities. Research on the impact of sociocultural factors in this area in the Chinese context is sparse.

METHODS

Semi-structured interviews were conducted with seven professionals (social worker, nurse, life skills trainer and manager) to explore their experiences of and attitudes towards the sexual needs of people with intellectual disabilities by applying interpretative phenomenological analysis.

RESULTS

The study identified two major themes, each with two sub-themes: 1. Professional handling of the sexual needs of people with intellectual disabilities (sex education and intervention); 2. Barriers (incompatible approaches and parental resistance). Participants also experienced feelings of resignation facing the barriers they encountered. Collectivism and cultural view about sex are potentially the influencing factors.

CONCLUSION

This study highlights the need to adopt an evidence-based sex education programme whose content and delivery should take account of cultural factors.

A meta-analytic review of attitudes towards the sexuality of adults with intellectual disabilities as measured by the ASQ-ID and related variables: Is context the key?

BACKGROUND

The attitudes of others towards the sexuality of people with intellectual disabilities are one of the main perceived barriers to them expressing their sexuality. Research on what influences these attitudes yields heterogeneous results.

METHOD

A systematic review of the literature and a meta-analysis were carried out.

RESULTS

Eleven studies using the Attitudes to Sexuality Questionnaire-Individuals with an Intellectual Disability (ASQ-ID) were included. Within the included studies, the country's socio-economic development and level of individualism were associated with attitudes towards the sexual rights, parenting and self-control of adults with intellectual disabilities. General population and staff samples held more favourable attitudes than family samples in terms of sexual rights and parenting. Age and gender did not yield significant results.

CONCLUSIONS

Variables related to country context may underlie the differences observed between countries and therefore influence the population's general thinking and ideologies. Unexpectedly, no age differences were observed. Gender-related results may reflect rapprochement between genders in sexuality. These findings are relevant for researchers and practitioners, as they suggest the importance of considering contextual factors when developing effective interventions that aim to support adults with disabilities to live their sexuality.

Factors associated with condom use in vaginal intercourse among Spanish adults with intellectual disability: Proposal for an explanatory model

BACKGROUND

The prevention of HIV or other STIs in people with intellectual disabilities (ID) is a rarely studied subject even though this population group is at the same risk of infection as the general population.

AIMS

The present study aims to conduct a descriptive analysis of sexual behaviours and condom use frequency in Spanish men and women with intellectual disabilities and identify the combination of variables that best explain condom use in vaginal intercourse.

METHODS AND PROCEDURES

The sample consisted of 253 people (56.1 % male and 43.9 % female) aged between 20 and 64 years (M = 38.52; SD = 10.48). Participants completed the Sexuality Questionnaire for People with Intellectual Disabilities and the Sexual Abuse Risk Screening Scale.

OUTCOMES AND RESULTS

The percentage of consistent condom use is 27.7 % for vaginal intercourse. Lack of knowledge about body boundaries constitutes a risk factor contributing to risky sexual behaviour. Knowledge of HIV-transmitting fluids and perceived self-efficacy are protective factors. The proposed model explains between 35.5 % and 46.6 % of the variance.

CONCLUSIONS AND IMPLICATIONS

The results highlight the importance of considering the judgements people make about their ability to perform preventive behaviour and the provision of information on sexuality adapted to cognitive abilities to minimise the engagement in risky behaviours.

Sexual Health in Spanish People with Intellectual Disability: the Impact of the Lockdown due to COVID-19

INTRODUCTION

The lockdown due to COVID-19 affected the sexual health of the people with intellectual disabilities by differentially modifying the frequency and characteristics of people's sexual activity depending on whether or not they lived with a partner during this period. The aim of this study was to analyze the extent to which the sexual behavior of people with intellectual disabilities (with and without a partner) was affected during the lockdown.

METHODS

The sample consisted of 73 people with intellectual disabilities between 21 and 63 years old (M = 39.63; SD = 10.11). The variables analyzed were the physical, social, and technological environment during the lockdown, sexual appetite, sexual behavior, online sexual activity, and sexual abuse. The data were collected between the months of May and June of 2020.

RESULTS

The lockdown increased the sexual appetite of a third of the sample (38%), especially the youngest participants. Sexual activity focused on autoeroticism and online behavior, particularly sending nude images of oneself (88%) and viewing pornography (83.6%). Rates of sexual abuse during this period were relatively high (6.8%).

CONCLUSIONS

The sexual activity of people with ID was important during the lockdown, and they had to adapt to the circumstances of isolation in a similar way to the general population. Technological improvements in terms of devices and connection quality at home allowed their sexual behavior to be reoriented, opening the door to new risks for the sexual health of people with ID.

POLICY IMPLICATIONS

Cybersex and the increase in sexual abuse due to confinement are aspects that should be included in programs to improve the sexual health of this group.

Attitudes Towards the Sexuality of Adults with Intellectual Disabilities: A Systematic Review

Current research in attitudes towards the sexuality of adults with intellectual disabilities yields heterogeneous results. The aim of the present paper was to systematically review current qualitative and quantitative evidence of attitudes towards the sexuality of adults with intellectual disabilities. A systematic review of current literature (2000–2020) was carried out in the ERIC, PsychINFO, SCOPUS, PUBMED, and WebOfScience databases. Thirty-three articles were included for review. The present review protocol is registered in the PROSPERO database. Included studies presented attitudes towards the sexuality of adults with intellectual disabilities in samples comprised of staff, family, members of the community, and adults with intellectual disability. Community samples held more positive attitudes, followed by staff and family. Adults with intellectual disabilities reported interest in intimate relationships but perceived barriers in others’ attitudes. Factors such as familiarity, age, gender of the adult with a disability, and culture seemed to have clear relationships. Other factors such as gender or social status remain unclear. In general, attitudes were considered positive. However, a preference for low intimacy and friendship or Platonic relationships was found. Stereotypes towards intellectual disability may have a strong influence. These findings underline the need to investigate and address attitudinal changes to provide adequate support for adults with intellectual disabilities in regard to a healthy relational and sex life.

Prospero registration number: CRD42021222918.