Caregivers’ Experiences in Providing Sexual Health Care to People with Intellectual Disabilities in Rural Thailand: A Qualitative Study

Sexual health is a fundamental human right; however, people with intellectual disabilities remain vulnerable to sexual harm and have limited opportunities to build skills for self-protection. In rural settings with constrained resources, family caregivers often carry primary responsibility for day-to-day sexual health support. This descriptive phenomenological study explored caregivers’ lived experiences of supporting sexual health for people with intellectual disabilities in Mueang District, Nakhon Phanom Province, Northeast Thailand. Data were gathered from January to August 2024 via in-depth interviews with 39 family caregivers and analyzed using Colaizzi’s seven-step method. Four themes emerged: (1) the meaning of sexual health as everyday safeguarding, (2) sexual health challenges among people with intellectual disabilities, (3) caregivers’ sexual health care practices, and (4) caregivers’ support needs. Caregivers described sexual health support as protection-oriented work shaped by culturally embedded modesty and discomfort with sexual talk, enacted through close supervision, puberty- and hygiene-related care, monitoring media and online exposure, and repeated boundary teaching to prevent deception, abuse, and unintended sexual consequences. Caregivers also reported limited confidence, low sexual health literacy, and a lack of practical, locally appropriate guidance. The findings highlight the need for nurse-led, culturally sensitive interventions in community settings, including caregiver communication coaching, literacy-appropriate educational materials, and clear referral pathways to multidisciplinary support.