Sexual health literacy among adults with intellectual disabilities: a scoping review

Background: Although sexual health literacy is recognised as critical to sexual health and well-being, little is known about how people with intellectual disabilities acquire or use sexual health literacy skills. This scoping review examined research to explore what is known about sexual health literacy among adults with intellectual disability. Method: We used Arksey and O"²Malley's scoping framework to guide our review. We searched five electronic databases and reference lists of full-text articles. Inclusion criteria included (i) original research in peer reviewed journals; (ii) published in English; (iii) addressed perspectives or experiences of people with intellectual disabilities regarding sexual health literacy or related topics. Findings were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews (PRISMA-Scr). All text labelled 'results', 'findings' or 'discussion' was subjected to interpretive content analysis. Results: The search strategy identified 5447 records, 102 met all eligibility criteria and were included for review. A conceptual framework to understand factors shaping sexual health literacy was developed. In this framework, sexual health literacy is underpinned by two fundamental pillars: sexual knowledge and sexual autonomy. The availability of sexual knowledge and sexual autonomy is threatened by several factors in the social environment: presumed sexual vulnerability and sexual incompetence, and expectations of heteronormativity and asexuality. Combined these factors reduce opportunities for acquisition of sexual knowledge and enactment of sexual autonomy and ultimately appear to limit sexual literacy among people with intellectual disabilities. Conclusion: Sexual health literacy is critical for people with intellectual disabilities to enjoy full sexual citizenship. Despite this limited attention has been paid to supporting people with intellectual disabilities to acquire and use sexual health literacy skills. Comprehensive education programs are needed to address this gap and ensure the rights of people with intellectual disabilities to engage in safe, pleasurable sexual experiences and enjoy good sexual health are upheld.