Background Para athletes from less-resourced countries have the highest need for protection against abuse in sport; however, their experiences and perceptions of abuse have not been studied.

Objective To describe Para athletes’ experiences and perceptions of abuse in sport, and systematically investigate the sociocultural drivers of those perceptions to inform culturally-relevant strategies to better protect vulnerable athletes.

Design Qualitative data were collected in the form of focus groups with Para athletes from Ghana, Brazil, and India. Data were analyzed using the Framework Method for Multidisciplinary Qualitative Analysis and transcripts were coded and analyzed by the research team.

Setting Focus groups were conducted with Para athletes at the National Paralympic training center in Accra, Ghana and virtually via Zoom.

Participants Twenty-six national- and international-level Para athletes with varying disabilities, 18 years or above, living and training in Ghana, India, or Brazil.

Main Outcome Measurements Four a priori themes with multiple subthemes were considered: characteristics of, effects of, growth after, and strategies to address abuse.

Results Athletes described a wide range of harms experienced both within and outside of sport. In addition to more commonly recognized modes of abuse such as physical and sexual, athletes focused on three less easily recognized forms of abuse: financial abuse, neglect, and disability stigma. Athletes described abuse as operating on both interpersonal and systemic levels. Cultural and societal factors influenced athletes’ perceptions and experiences of harms.

Conclusions Para athletes from less-resourced countries represent the largest pool of global sportspersons eligible for Olympic-level participation, and have the highest need for protection against abuse, but their voices are seldom heard. Sport stakeholders concerned with abuse prevention must understand their experiences and integrate their insights and priorities into sport safeguarding policies, programs, and interventions. As new insights are added to the current evidence base, athlete-generated and locally-relevant preventative strategies can better protect all athletes.