HIV and AIDS and Disability

In recent years, HIV and AIDS is being recognized as a growing problem among people with disabilities. Research indicates that people with disabilities are at equal or higher risk to HIV infection compared to non-disabled people, are highly vulnerable to sexual violence, and lack access to information, prevention, and treatment and care services. Women with disabilities, disabled members of ethnic and minority communities, disabled adolescents, and people with disabilities who live in institutions are particularly at a greater risk of contracting HIV.

Additionally, people living with HIV are likely to experience temporary and/or chronic impairments at different phases due to acquired infections and side effects from taking antiretroviral drugs which can prevent their full and equal participation in society.

Despite increasing awareness, the field of HIV and AIDS and Disability remains largely overlooked. It is essential that further research is completed for evidence-based policy and programming, and that policy and programmatic responses are integrated to promote inclusive practice and the mainstreaming of disability in HIV and AIDS development initiatives. This relates closely to article 25 of the Convention on the Rights of People with Disabilities.

This keylist aims to raise awareness on the issue of HIV and AIDS for people with disabilities, providing access to key documents, tools and resources to support development practitioners, service providers, policy makers and people with disabilities.

We welcome your suggestions: please send comments or suggested additions to sourceassistant@hi-uk.org.

Selected resources

Policies, briefs and rights

Disability and HIV policy brief

JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS),
WORLD HEALTH ORGANIZATION (WHO),
OFFICE OF THE HIGH COMMISSIONER FOR HUMAN RIGHTS (OHCHR)
April 2009

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This policy brief discusses the actions needed to increase the participation of persons with disabilities in the response to HIV and to ensure that they have access to HIV services which are both tailored to their diverse needs and equal to the services available to others in the community. Recommendations of actions for governments, civil society and aid agencies are provided, having been defined in consultation with a broad range of stakeholders including people living with HIV and persons with disabilities. An example from South Africa is highlighted. This document is beneficial for anyone working in disability and development with HIV and AIDS

Disability and HIV/AIDS : at a glance

WORLD BANK
November 2004

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This factsheet looks at the risk faced by disabled people, in particular their vulnerabilty to HIV. It also includes a summary of the types of action that could be taken for HIV/AIDS prevention among disabled people

Framework for the inclusion of disability in the national strategic plan on HIV and AIDS

THE GLOBAL CONTACT GROUP ON AIDS AND DISABILITY (GCGAD) NSP TASK GROUP

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"This framework is a tool to guide the development and review of NSPs across the globe in terms of their disability-inclusiveness, and to realize the commitments of the CRPD and the International Guidelines on HIV/AIDS and Human Rights in advancing important policy frameworks in the context of HIV and AIDS. The framework, its language and its content, has been developed in alignment with regional and international commitments relating to HIV and to disability. It reflects the structure and format of current NSPs and includes step by step guidelines on integrating disability into plans and programmes at different levels"

HEARD disability and HIV/AIDS issue and policy brief released

HEALTH ECONOMICS AND HIV/AIDS RESEARCH DIVISION (HEARD)
March 2010

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This article gives an update of HEARD's Disability and HIV/AIDS Project, which has produced an issue brief and a policy brief, for which links to PDFs are provided. The issue brief is entitled: 'HIV, Disability and Rehabilitation'. It looks at the links between HIV and disability and the implications for rehabilitation services and disability support grants in resource poor settings. The policy brief, 'National Response to Disability and HIV in eastern and southern Africa', gives an analysis of the national strategic plans on HIV and AIDS within the region and the largely limited recognition of the need to include people with disabilities

HIV, AIDS and disability

INTERAGENCY COALITION ON AIDS AND DEVELOPMENT
2008

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This paper briefly outlines the need for collaboration between those advocating the rights of people with disabilities, and those active in the field of HIV and AIDS prevention. It gives an overview of recent studies in the field, and provides information on initiatives which address the issues of disability and HIV and AIDS in Africa and Asia. This document would be useful for people looking for an initial introduction to the cross-cutting issue of HIV and disability with examples from existing programmes in the field

HIV, disability and discrimination : making the links in international and domestic human rights law

ELLIOTT, Richard,
UTYASHEVA, Leah,
ZACK, Elisse
November 2009

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This article looks at the links between HIV and AIDS and disability; gives a brief overview of how both are treated in international human rights law; and looks at some of the ways in which national anti-discrimination laws reflect the links between HIV and AIDS and disability, with representative examples from various countries. The conclusions and recommendations suggest how future collaborations between HIV and disability rights activists might advance human rights at the international level, for example by making use of the UN Convention on the Rights of Persons with Disabilities

IDDC policy briefing on HIV and AIDS and disability

INTERNATIONAL DISABILITY AND DEVELOPMENT CONSORTIUM HIV AND AIDS AND DISABILITY TASK GROUP
June 2012

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This policy brief presents information highlighting that persons with disabilities are at equal or higher risk of HIV infection than the rest of the community for the following reasons: poor access to information on sexual and reproductive health and HIV&AIDS; poor access to health care, including HIV&AIDS services; poverty and marginalisation; and high rates of sexual abuse and exploitation. Recommended actions are provided to increase the participation of persons with disabilities in the HIV response and ensure they have access to HIV services

Inclusive and integrated HIV and AIDS programming : promoting universal access for all

MAC-SEING, Muriel
July 2012

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"This policy paper describes Handicap International’s mandate and values in operational terms as applied to the theme of inclusive and integrated HIV and AIDS programming. It presents the approaches and references for Handicap International’s actions, choices and commitments. It aims to ensure coherence in terms of practices whilst taking into account different contexts. Essentially this is a guidance document for programme staff which defines the topic and outlines the target populations, methods of intervention (expected results, activities) and indicators for monitoring and evaluation. This policy aims to ensure that all projects carried out by Handicap International programmes are consistent with the methods of intervention presented"
PP 07

Kampala declaration on disability and HIV & AIDS

AFRICA CAMPAIGN ON DISABILITY AND HIV & AIDS
March 2008

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This document is a call by the participants of the second meeting of the Africa Campaign on Disability and HIV&AIDS in March 2008, to all African governments to include disability in its diversity as a crosscutting issue in all poverty reduction strategies. A list of signatories is included

National response to disability and HIV in Eastern and Southern Africa

HANASS-HANCOCK, Jill,
GRANT, Kitty
February 2010

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Although people with disabilities are often at increased risk of exposure to HIV, this policy brief outlines that less than half of the national strategic plans in Eastern and Southern Africa recognise disability as an issue of concern. Recommendations are provided to governments and civil society on how to address the issue effectively. This policy brief would be useful to people interested in HIV policies in Africa

Nothing about us... without us : HIV, AIDS and disability in South Africa

BOGOPANE-ZULU, Hendrietta
et al
2008

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This report documents the experiences of disabled people in responding to HIV and AIDS in South Africa. It tells the personal stories of two individuals with disabilities who were also diagnosed with HIV, and looks at the response of the disability sector, government and other stakeholders to the HIV challenge. Giving examples of disability specific HIV and AIDS programmes, the report concludes with a lessons learned section. It would be for people interested in disability and HIV in Africa

Towards and AIDS-free generation : promoting community based strategies for and with children and adolescents with disabilities

MERESMAN, Sergio
July 2012

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This resource highlights that children and adolescents with disabilities are critical to achieving an AIDS-free generation. It provides information about family- and community-based responses for a disability-sensitive AIDS-free generation, and specific recommendations for working with children, adolescents and young people with disabilities in HIV programmes. Opportunities and entry points for implementation are given, as well as examples of materials developed by adolescents with disabilities and community-based organizations

UNAIDS strategy for integrating disability into AIDS programmes

JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS)
2012

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The purpose of this report is to "increases awareness of the structural barriers that people with disabilities experience in accessing good-quality services. The strategy promotes broad action to achieve universal access to HIV prevention for people with disabilities through full integration into all aspects of the HIV response"
Issues brief JC2362

HIV, disability and rehabilitation

HIV, disability and rehabilitation : considerations for policy and practise

HEALTH ECONOMICS AND HIV/AIDS RESEARCH DIVISION (HEARD)
January 2010

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This issue brief considers the links between HIV and disability - that people with disabilities are among the key populations at high risk to exposure to HIV, and that people living with HIV may develop impairments and disabilities as a result of the disease. It anticipates an increased demand for rehabilitation services in Eastern and Southern Africa, given the improved access to HIV treatments and high prevalence of people living with HIV in the region, and warns that many in areas services are already stretched and resource-poor, so may struggle to cope with greater demand. The brief focuses on: issues regarding the definition of disability; implications for rehabilitation services; and considerations for disability grants

Mainstreaming of disability and HIV/AIDS : a double challenge

DE GREVE, A
2005

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This paper describes how organisations take into account, or mainstream, disability and/or HIV and AIDS in their work. In the introduction, guest writer Nora Groce discusses the link between disability and HIV/AIDS and the similarities between the issues. The next chapters examine different forms of mainstreaming, and then discuss the arguments for and against mainstreaming disability and/or HIV/AIDS. Chapter 3 deals with the basic principles of the mainstreaming process. Chapter 4 discusses the integration of the disability and/or HIV/AIDS factor in development activities. This includes activities of and with partners in the South, ie socio-economic projects, awareness raising and training activities in the South. It discusses how mainstreaming implicates the representation and participation of persons with a disability and/or living with HIV or AIDS, and the relevant interest organisations representing both groups, in the initial phases of the project as well in implementation. Chapter 5 deals with mainstreaming in organisational policy. There is a need for Northern NGOs as well as Southern partners to actively adapt their policy to take into account disability and/or HIV/AIDS. Both themes should be integrated into the whole organisational structure, and taken into account when setting up activities and in workplace policy

Putting episodic disability into context : a qualitative study exploring factors that influence disability experienced by adults living with HIV/AIDS

O'BRIEN, Kelly K
et al
November 2009

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"An increasing number of individuals may be living with the health-related consequences of HIV and its associated treatments, a concept we term disability. However, the context in which disability is experienced from the HIV perspective is not well understood. The purpose of this paper is to describe the contextual factors that influence the experiences of disability from the perspective of adults living with HIV"

Rehabilitation : a crucial component in the future of HIV care and support

NIXON, Stephanie
et al
June 2011

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"Provision of antiretroviral therapy (ART) is not an end in itself but a means to achieving improved wellness for people living with HIV. Rehabilitation, broadly defined, is another key contributor to wellness within this context. Understanding the potential for rehabilitation requires that one is able to consider HIV not only within a biomedical model that focuses on body systems, diagnoses and symptoms, but also within a rehabilitation framework that focuses on how these diagnoses and symptoms affect people’s lives more broadly. Furthermore, rehabilitation is a human rights imperative, which deserves the energetic attention enjoyed by other aspects of HIV treatment and care. In particular, the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) is shining a long-overdue spotlight on the human rights imperatives associated with disability. For South Africa and other countries, proactively and meaningfully engaging rehabilitation in the HIV response will require major shifts on several fronts, including practice, education, policy and research. We argue that in settings where ART delivery is now widespread, HIV should be understood not only as a medical issue, but as a rehabilitation and disability concern. Whereas medicine adds years to life, it is rehabilitation that aims to add life to years"
Southern African Journal of HIV Medicine, Vol 12, No 2

The fields of HIV and disability : past, present and future

HANASS-HANCOCK, Jill,
NIXON, Stephanie A
November 2009

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This article gives a historic overview of the two fields of disability and of HIV. The first field involves people living with HIV and their experiences of disability brought on by the disease. The second field involves people with disabilities and their experiences of vulnerability to, and life with, HIV. The authors argue that although these two fields have evolved relatively independently over time, the divide between them is collapsing, with the result that new understanding about shared concerns and the mutual benefits that may be gained from integrating policies. This resource would useful for people interested in the field of disability and HIV in general

The influence of HIV/AIDS on community-based rehabilitation in Dar es Salaam, Tanzania

BOYCE, William,
COTE, Laurence
January 2009

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This paper examines the impact of HIV and AIDS on community-based rehabilitation (CBR) in Dar es Salaam, Tanzania. Over a three-month period, observational sessions and individual interviews were conducted with caregivers of children with disabilities, CBR workers and managers. Among the findings was a significant decrease in CBR activities in families affected by HIV and AIDS. It is recommended that further integration of CBR work with general health development initiatives might improve this situation

Manuals, training tools, guidelines and good practices

A handbook on best practices regarding HIV and AIDS for people with disabilities : services, policy advocacy, programming

NDUTA, Sarah
et al
November 2009

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This handbook aims to further increase awareness of HIV and AIDS for people with disabilities, to share knowledge and to provide examples of best practices. It also examines the impact of the AIDS epidemic on people with disabilities and advocates inclusion of people with disabilities to HIV prevention, treatment, care and support. The handbook is divided into four chapters, each addressing a specific topic in reference to best practices for Disability and HIV and AIDS. Case studies are provided for each topic. The categories of disabilities covered in the handbook are the deaf, visually impaired, physically and intellectually challenged. This handbook is useful for organisations, policy makers, disabled people's organisations and donors interested in Disability and HIV and AIDS

Are your rights respected?

MELETSE, John,
MOTSWAI, Tommy
2006

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This publication addresses issues of HIV prevention, sexual violence and sexual rights and was primarily designed for the deaf community in South Africa. It tells the story of a group of students at a deaf school confronting issues of sexual health and violence, and describes how they learn to deal with them. Due to low levels of literacy and limited health care access, and despite being the largest disability group in South Africa, deaf people are generally little aware of the health implication of sexual behaviours and of their sexual rights. Contains vital and well targeted information presented in a simple and accessible way

Capacity building in network organisations : experiences from and practical guidelines for HIV and other networks

SLUIJS-DOYLE, José
November 2009

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This report assesses seven capacities of organisations of people living with HIV and other HIV network organisations to see what makes a well-functioning network. These capacities are: involvement and accountability; partnership alliances; leadership; knowledge and skills; internal communication; impact, outputs and external communication; and management and finance. The report looks at four network organisations in Eastern and Southern Africa, with secondary research drawn from networks in Bangladesh, Nepal and India. The findings and recommendations cannot be applied universally to capacity strengthening in all network organisations, but need to be adapted to the context of each particular group

Guidelines for inclusion of individuals with disability in HIV/AIDS outreach efforts

GROCE, Nora,
TRASI, Reshma,
YOUSAFZAI, Yousafzai
2006

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The strategies for interventions proposed here can provide a framework upon which disability advocates and HIV and AIDS advocates, educators and policy makers can begin to build interventions and support mechanisms for ‘at-risk’ disabled populations. To date, there have been few HIV and AIDS interventions that have directly targeted (or indirectly included) individuals with disability and almost none of these interventions have been systematically monitored or evaluated. The framework proposed here therefore, is intended only as a ‘first step’ in a series of publications on various aspects of disability-inclusive HIV and AIDS interventions and tool kits

HIV & AIDS "train the trainers" manual

AFRICA UNION OF THE BLIND (AFUB)
2010

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"This manual is for use by Trainers of Trainers. i.e. trainers of visually impaired Peer Educators. It has been developed to provide awareness and training on HIV&AIDS prevention, treatment, care and support and to equip blind and partially sighted participants with Peer Educations skills. It is hoped that blind and partially sighted participants will become effective Peer Educators in training other visually impaired persons in their communities"
The user has given permission for the uploaded document to be reproduced and made publicly available on the Source website

HIV and your disability equality scheme : a practical guide for chief executives, board members and senior managers

NATIONAL AIDS TRUST (NAT)
2006

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This guide provides practical advice to chief executives, board members and senior managers of public bodies in the UK, who are developing or reviewing their disability equality scheme. It also offers important information relating to HIV, to enable public bodies to meet their general duty of promoting disability equality under the UK Disability Discrimination Act 2005

Preventing HIV/AIDS among persons with disabilities : a handbook for policy makers, healthcare providers and care givers of people with disabilities

IVOM, Damian O
2009

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This handbook highlights the factors responsible for the spread of HIV, methods of preventing it within persons with disabilities and how they can be reached and integrated into HIV and AIDS programmes and activities, so as to cause a reduction within its communities and in the general population. It is premised on the fact that many programmes and activities on HIV and AIDS in developing countries especially Sub-Saharan Africa have not realised the need to include persons with disabilities

Resource manual for disability and HIV/AIDS training

TATARYN, Myroslava
Ed
2006

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This manual was designed for individuals and organisations who want to learn more about disability and HIV and AIDS, and share this information with others. Each chapter follows the story, and dialogue between two disabled people actively learning about HIV and AIDS and their disabilities. Within the context of the characters, this guide provides extensive information on sexuality, HIV biology, prevention, testing and stigma. This resource would be useful for any one with an interest in approaches to disability, HIV and AIDS education and disability and development

The deaf peers' education manual : a training manual, developed by the Kenyan Peer Education Network, with interactive-based activities for basic understanding of sexual health, HIV and AIDS

June 2007

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The purpose of this manual is to provide deaf youth and adults, teachers, parents and guardians with a tool for addressing basic health awareness within an independent framework utilising optimal communication. The activities are participatory and interactive, and are designed with and by deaf Kenyans fluent in Sign Language (SL), and acknowledge the use of other SL variations within the various deaf groups. The three main issues addressed cover sexual education, relationships and hygiene. The manual is designed to blend with the school curriculums/co-curriculum activities, plus other issues that affect students while in school. It also befits other settings such as seminars and workshops, and can be used to tackle a specific subject. It is appropriate for varied ages, communities, cultures, religions, and literacy levels

Training of trainers manual on disability-inclusive HIV services and disability-inclusive sexual and reproductive health for health workers

ADEREMI, Toyin Janet
September 2011

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This training of trainers manual has been designed as a guide for providers of HIV prevention, treatment, care and support and sexual and reproductive health (SRH) services to ensure services are disability-inclusive. This training is divided in 5 parts: Part 1 - Introduction; Part 2 - Disability awareness and disability inclusion; Part 3 - Disability-inclusive HIV prevention, treatment, care and support services; Part 4 - Disability-inclusive sexual and reproductive health services; Part 5 - Disability-inclusive HIV prevention integrated into sexual and reproductive health services. This manual is useful for anyone interested in trainings on disability-inclusive HIV services and disability-inclusive sexual and reproductive health for health workers
Note: the manual is available to download in three parts using the links provided

Online libraries and clearing houses

Canadian working group on HIV and rehabilitation

THE CANADIAN WORKING GROUP ON HIV AND REHABILITATION (CWGHR)

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The Canadian working group on HIV and rehabilitation (CWGHR) is a national, charitable organization that responds to the rehabilitation needs of people living with HIV/AIDS. This website presents general information about the working group, featuring their members, publications, research and newsletters. It also provides detailed education information and resources for people living with HIV, health and social care providers and employers. This resource is useful for anyone interested in HIV and rehabilitation

HEARD’s disability and HIV library

HEALTH ECONOMICS AND HIV/AIDS RESEARCH DIVISION (HEARD)
June 2010

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This bibliography contains papers, reports and articles relating to the issue of HIV and AIDS and disability. "These papers reveal findings in relation to the impact of HIV/AIDS on people with disabilities, the disabling effects of HIV/AIDS, sexuality and disability, the attitude and stigma towards disability and interventions in different countries"

HIV and AIDS and disability

INTERNATIONAL DISABILITY AND DEVELOPMENT CONSORTIUM (IDDC)

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This section of IDDC’s website highlights HIV and AIDS and disability information. It presents general HIV and AIDS and disability information, the HIV and AIDS and disability task group’s focus and related activities, as well as other key resources and partner activities

HIV/AIDS and disability : an exploration of organizations' responses to HIV/AIDS as it affects people with disabilities

ROHLEDER, Poul Andrew
2008

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This dissertation in clinical psychology explores the extent to which South African schools and organisations that work with persons with disabilities deal with issues of HIV and AIDS. The study indicates that although HIV education takes place, issues relating to HIV and AIDS are handled with much anxiety. The results reveal that in some cases HIV education is used to control and oppress disabled people’s sexual expression, instead of empowering them to have fulfilling sexual lives. Issues regarding sexual abuse and rape are also discussed. The dissertation ends with recommendations regarding further research on disabled people’s experiences and the need to address the silence around issues such as rape and abuse. This resource would be useful for people looking for in-depth information on disability and HIV in general (chapters 2 and 3), and with a focus on South Africa in particular (chapters 5 to 7). Moreover, it would be useful to people interested in the psychological aspects of working in the field of HIV (chapter 4)

Studies, reports and case studies

"We are also dying of AIDS” : barriers to HIV services and treatment for persons with disabilities in Zambia

CHOPRA, Rashmi
July 2014

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This report documents the obstacles faced by people with disabilities in both the community and healthcare settings. These include pervasive stigma and discrimination, lack of access to inclusive HIV prevention education, obstacles to accessing voluntary testing and HIV treatment, and lack of appropriate support for adherence to antiretroviral treatment. The report also describes the sexual and intimate partner violence women and girls with disabilities face, and the need for the government and international donors to do more to ensure inclusive and accessible HIV services

 

Note : Accessible and easy read versions are available from the link above

'The forgotten' HIV and disability in Tanzania

TANZANIA COMMISSION FOR AIDS (TACAIDS)
2009

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This is the report of a study into HIV and disability in Tanzania. it assesses the impact of HIV and AIDS on people with disabilities; evaluates disabled people's access to information, testing and services; and makes recommendations for overcoming barriers and obstacles to improve access to HIV services. Qualitative and quantitative information was collected from people with disabilities, disabled people's organisations and HIV organisations in four districts close to Dar es Salaam. This report would be particularly relevant to those with an interest in HIV and disability in Tanzania

Access to HIV/AIDS and sexual violence protection services among women and men with hearing, visual and physical impairments in Battambang and Kampong Cham provinces of Cambodia

MAC-SEING, Muriel
August 2010

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"This article presents the findings of a study on access to HIV prevention and sexual violence protection services among persons with disabilities in Cambodia, based on a gender and cross-impairment analysis. The results show obvious discrepancies between women and men of different impairments in regards to their level of HIV knowledge and risks to sexual violence, in particular among women with disabilities. Furthermore, local services providers revealed their lack of awareness on disability issues and capacity in providing accessible services to them. Ways forward in addressing the rights of women and men with disabilities, as well as gaps in services delivery will have to be addressed in concerted manners at political, societal and community levels"

Challenges faced by people with disabilities (PWD'S) in utilizing HIV/AIDS communication and related health services in Uganda

OPOLOT, Samson James
et al
January 2005

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This qualitative study was designed to explore the experiences of people with disabilities in accessing information about HIV in Uganda. The results show that Uganda’s health care system is ill equipped to meet the needs of people with disabilities, especially with regards to language and mobility services. This particularly impacts women and children with disabilities. There is an extensive list of recommendations as to how these issues could be addressed. This study would be of interest to professionals working in the field of health care and/or with people with disabilities in Uganda

Differences in HIV knowledge and sexual practices of learners with intellectual disabilities and non-disabled learners in Nigeria

ADEEMI, Toyin,
PILLAY, Basil,
ESTERRHUIZEN, Tonya
February 2013

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"This study sought to compare the HIV knowledge and sexual practices of learners with mild/moderate intellectual disabilities and non-disabled learners (NDL) in Nigeria. Findings could help in the development of HIV interventions that are accessible to Nigerian learners with intellectual impairments"
Journal of the International AIDS Society, Vol 16

Disability and HIV & AIDS : a participatory rapid assessment of the vulnerability, impact and coping mechanisms of the disabled people on HIV/AIDS

NGANZI, Patrick,
MATONHODZE, George
2004

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This study assesses the vulnerability, impact and coping mechanisms of disabled people on HIV and AIDS, and suggests strategies for developing an HIV and AIDS programme for disabled people’s organisations. Using participatory methodologies of inquiry, the study found that disabled people perceive themselves to be at higher risk of HIV infection due to their disability, regardless of their awareness levels. Their social exclusion from the mainstream HIV/AIDS services makes the situation worse. The study revealed that the many myths and misconceptions around HIV and disability increase the vulnerability of disabled people to HIV/AIDS, such as the belief that sex with a disabled person cleanses a person of HIV/AIDS. It also revealed that disabled people have limited access to HIV/AIDS information and limited use of HIV/AIDS services mainly because of the nature of their disability, the location of the facilities and the attitudes of service providers. In conclusion, the study revealed that disabled people are at a higher risk of infection by sexually transmitted infections and HIV/AIDS due to their exclusion from mainstream HIV interventions. This situation is further exacerbated by the lack of policy framework on disability and HIV and AIDS

Disability and HIV : a systematic review and a meta-analysis of the risk of HIV infection among adults with disabilities in Sub-Saharan Africa

DE BEAUDRAP, Pierre,
MAC-SEING, Muriel,
PASQUIER, Estelle
July 2014

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"More than one billion people worldwide are estimated to be living with a disability. A significant proportion of them lives in Sub-Saharan Africa where they are reported to be at increased risk of HIV. However, quantitative evidence on this remains scarce. A systematic review and a meta-analysis of the risk of HIV infection among people with disabilities living in Sub-Saharan Africa were undertaken. We searched all published or unpublished studies and national surveys reporting HIV prevalence among adults with disabilities living in Sub-Saharan Africa between 2000 and 2013. The risk ratio (RR) of HIV infection in people with disabilities versus people without disabilities was estimated through a random-effects meta-analysis. Of the 12,252 references screened, 13 studies were selected. HIV prevalence varied widely across studies from 1.1% to 29%. Pooled RRs of HIV infection in people with disabilities compared to the general population were 1.31 (1.02–1.69) overall; 1.16 (0.71–1.87) among people with mental illness or intellectual disabilities and 1.07 (0.58–1.95) among people with hearing disabilities. This meta-analysis provides evidence that people with disabilities do not have a lower risk of HIV when compared to the general population, and that women with disabilities are especially affected. A clear increasing gradient in the risk of HIV according to gender and disability status was also observed. The important heterogeneity across studies and their varying quality warrant a closer look at the intersection between disability and HIV. Additional studies with more systematic approaches and with higher-quality methodologies are required to further address this knowledge gap"

 

AIDS Care : Psychological and Socio-medical Aspects of HIV/AIDS, Volume 26, Issue 12

DOI: 10.1080/09540121.2014.936820

 

Disability and HIV : what drives this relationship in eastern and southern Africa?

HANASS-HANCOCK, Jill,
REGONDI, Ilaria,
NAIDOO, Kerisha
February 2013

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"This article uses global socio-economic and HIV datasets and compares them to data contained in the most recent World Report on Disability in order to examine the relationship between HIV and disability in Eastern and Southern Africa (ESA). The analysis suggests that disability prevalence may be related to HIV-prevalence in ESA. It identifies research and policy gaps and seeks to shed light on the relationship between the two phenomena. It concludes that, more than any other region in the world, ESA needs to ensure better data collection on disability and the inclusion of disability throughout its HIV programmes in order to provide a comprehensive and appropriate response to the epidemic"

African Journal of Disability, Vol 2, No 1 

Disability and HIV/AIDS : a systematic review of literature on Africa

HANASS-HANCOCK, Jill
2009

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This article reviews all the literature about disability and HIV and AIDS in Africa in the past decade. It presents data from different surveys and summarises their findings. It also reveals gaps in the research (e.g. research on other disability groups other than the deaf population) and areas of concern (e.g. sexual abuse and the exploitation of people with disabilities). This article would be useful for people interested in research and studies related to the field of disability and HIV and AIDS in Africa

Double burden : a situation analysis of HIV/AIDS and young people with disabilities in Rwanda and Uganda

YOUSAFZAI, Aisha,
EDWARDS, Karen
2004

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This analysis was carried out by Save the Children UK after reports from the field suggested that disabled people were not accessing HIV prevention information or services, despite being at higher risk of infection. It outlines ways in which disabled people are not fully included in safer-sex communications: for instance blind people hear talk about condoms, but have never held one; the necessity to have a sign-language interpreter for deaf people compromises their right to confidentiality; young girls with disabilities are more likely to be raped and are less able to negotiate safe sex. It recommends the greater integration of disabled people into health and HIV communications and further research to develop disabled-friendly means of communication

Effective HIV/AIDS and reproductive health information to people with disabilities

MUNTHALI, Alister,
MVULA, Peter,
ALI, Sandra
October 2004

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This study explores the sexual and reproductive health needs and experiences of people with disabilities, as well as perceptions about HIV and AIDS and disability. The purpose is to address the accessibility of health communication for people with different impairments. This study would be useful for anyone with an interest in HIV and AIDS and disability

Fostering disability-inclusive HIV/AIDS programs in northeast India : a participatory study

et al
June 2007

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"This paper summarises findings from a participatory study which aimed to develop practical guidelines to make HIV programmes in the states of Manipur and Nagaland more disability-friendly...The objectives were to: 1) explore HIV risk and risk perception in relation to people with disability (PWD) among HIV and disability programmers, and PWD themselves; 2) identify HIV-related education and service needs and preferences of PWD; and 3) utilise findings and stakeholder consultation to draft practical guidelines for inclusion of disability into HIV programming in this region of India"

HIV and AIDS knowledge, attitude, practices and accessibility study

HANDICAP INTERNATIONAL (HI)
August 2007

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This report concerns HIV and AIDS preventative activities targeting people with disabilities in Kenya. Specifically, the report gathers information concerning the knowledge, attitude and practices among people with disabilities; and qualitative and quantitative data including 618 questionnaires conducted in Nairobi and Mobassa. The report findings advise on the development of policy on HIV and AIDS for people with disabilities in Kenya

HIV-related disability in HIV hyper-endemic countries : a scoping review

HANASS-HANCOCK, Jill
et al
September 2013

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This article presents the results of the first scoping review to examine the extent, nature and range of disability among people living with HIV in HIV hyper-endemic countries. The studies indicate that people living with HIV experience a variety of disabilities. Impairments in body structure/function comprise the majority of data, with particular focus on mental function. Data on activity limitations and participation restriction were limited, however, they were recorded. They indicate severe impact on people’s life and possible adherence. The review argues that the time has come to elevate the focus holistically on health and life-related consequences of living with HIV and to integrate disability into the discussions and approaches to HIV care

World Journal of Aids, Vol 3, No 3

HIV/AIDS and disability : a pilot survey of HIV/AIDS knowledge among a deaf population in Swaziland

GROCE, Nora
et al
2006

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This paper reports on a quantitative study to identify whether there are differences in the level of knowledge about HIV and AIDS between hearing and deaf community members in Swaziland. Significant differences in levels of understanding of HIV issues were found, especially with regards to mistaken ideas about HIV transmission and prevention. The outcomes indicate the need for targeted education campaigns and improved accessibility in health care for deaf individuals in Swaziland. The article is useful for health and development professionals working in the field of HIV and AIDS, as well as those working with deaf individuals in Swaziland

HIV/AIDS and disability : differences in HIV/AIDS knowledge between deaf and hearing people in Nigeria

GROCE, N E,
YOUSAFZAI, A K,
VAN DER MAAS, F
March 2007

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This quantitative study compares HIV and AIDS knowledge among hearing and deaf individuals in Nigeria, in order to identify if, and in what way, deaf community members lack access to AIDS information due to low literacy or problems in communication. Significant differences in levels of understanding and access to accurate information were found, indicating the need for inclusion of people with disabilities in HIV and AIDS strategies, and the need to address their specific vulnerabilities. The article would be useful for health and development professionals working in the field of HIVand AIDS, or with deaf individuals in Nigeria

HIV/AIDS and disability: capturing hidden voices. Global survey on HIV/AIDS and disability

GROCE, Nora
April 2004

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This is a report of the global survey carried out by the Yale School of Public Health and the World Bank, into the research, policies and programmes that concern the impact of HIV/AIDS on disabled people. The report outlines the research methods used and the findings of the research. It concludes that HIV/AIDS represents a significant threat to disabled individuals and populations around the globe, at rates at least comparable to and quite possibly significantly higher than those affecting the general public. Moreover, findings from the survey clearly document that individuals with disability are not included in most AIDS outreach efforts

HIV/AIDS and individuals with disability

GROCE, Nora Ellen
2005

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This article looks at the impact of HIV on people living with permanent physical, sensory, intellectual, or mental health disability. In particular, it considers whether AIDS messages reach disabled populations and the inequity of access to health care that they face

Invisible : the notion of disability in the context of HIV/AIDS in Kwazulu-Natal, South Africa

HANASS-HANCOCK, Jill
January 2008

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This thesis explores how the cultural context in which people think about disability and HIV exposes disabled people to a higher risk of infection. To investigate this issue, this work analyses the macro-cultural, micro-cultural and individual level of people in the KwaZulu-Natal region of South Africa. This resource would be useful for anyone interested in the cultural aspects of disability and HIV and AIDS

Making HIV/AIDS our problem : young people and the development challenge in South Africa

KELLY, K
et al
March 2002

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During 2001 Save the Children commissioned a study to explore approaches to engaging youth response to HIV/AIDS. This involved the development of two action research interventions in very different communities, one in a rural community in the Eastern Cape, and the other at a school for the blind. The case studies chosen for the report were selected because they involve young people who have been particularly overlooked in HIV prevention responses, namely disabled young people and young people in rural areas. The projects in these communities set out to explore the capacity of young people to respond to AIDS, and how contextual factors mediate response at individual and community levels

Needs, barriers, and concerns regarding HIV prevention among South Africans with visual impairments : a key informant study

PHILANDER, John H,
SWARTZ, Leslie
February 2006

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This article reports on work preparatory to the development of a programme focusing on the needs of people with visual impairments in South Africa regarding HIV prevention. Fifteen participants were interviewed, most of whom were in senior positions of organisations in the field of visual impairment and the majority of whom had a visual impairment themselves. Their responses support the view that more work is needed regarding HIV prevention for persons with visual impairments in South Africa. Social exclusion was viewed as an overarching risk factor. This article may be of interest to those working with people with visual impairments in Africa

Predictors of voluntary HIV counselling and testing services utilization among people with disabilities in Addis Ababa, Ethiopia

ADEREMI, Toyin Janet
et al
June 2014

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“The study investigated HIV testing prevalence and factors associated with the utilization of voluntary HIV counselling and testing (VCT) services among individuals with disabilities in Addis Ababa. The analysis was based on a survey of 209 men and 203 women with disabilities, aged 15–49, who had ever heard about HIV and AIDS in four sub-cities in Addis Ababa. HIV testing prevalence was 53.2%, with no significant difference between males and females. Comprehensive HIV knowledge, living with spouse, and religious affiliations positively predicted utilization of VCT services among participants. Living with both parents and having physical or mental/intellectual disabilities were negative predictors of VCT services utilization. More research on the predictors of utilization of VCT services by gender and urban/rural divides are needed among people with disabilities”

AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, Vol 26, Issue 10

Promotion of a disability perspective into Uganda's national HIV/AIDS response

KANYESIGYE, Juliet,
ANGURIA, Joseph,
MBABAZI, Enid
February 2007

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This report presents findings of a survey conducted in Uganda into the knowledge, attitudes and behaviour of people with disabilities regarding HIV and AIDS and sexual and reproductive health (SRH) issues, as well as the knowledge and attitudes of SRH and HIV and AIDS service providers to disability. The study provides baseline information for a NUDIPU SRH, HIV and AIDS project, against which progress and achievements can be mesured, and makes recommendations for national and district level responses. It would be interesting to those working in the field of disability in Uganda

Sexual vulnerability and HIV seroprevalence among the deaf and hearing impaired in Cameroon

TOUKO, Adonis
et al
February 2010

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This article describes a study to investigate the prevalence of HIV in people who are hearing impaired among the population of Yaounde, the capital of Cameroon, and assess their sexual vulnerability, through interviews and, in most cases, HIV testing. The research concludes that hearing impairment is a significant risk factor for contracting sexually transmitted infections and HIV, and that more research is needed into the impact of HIV and AIDS on people with disabilities, particularly those who are hearing impaired, in order to tackle this vulnerability

South African national HIV prevalence, incidence, behavior and communication survey 2008 : turning a tide among teenagers ?

SHISANA, O
et al
2009

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"South Africa has the largest burden of HIV/AIDS and is currently implementing the largest antiretroviral treatment (ART) programme in the world. It is therefore fitting that South Africa is the first in the world to conduct three repeated national HIV population-based surveys to help monitor our response as a nation to the HIV/AIDS epidemic. This report is the third in a time series of population-based HIV seroprevalence surveys which started in 2002 and were repeated in 2005 and again in 2008"

Study on reproductive health and HIV/AIDS among persons with disabilities in Kampala, Katakwi and Rakai districts : knowledge, attitudes and practices

MULINDWA, Innocent Najjumba
May 2003

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This is the report of a study to investigate the reproductive health and HIV/AIDS of disabled people, and their beliefs, perceptions and reproductive health practices. It also identifies the constraints faced by disabled people in seeking reproductive health services and suggests strategies through which reproductive health delivery for disabled people could be improved. The report calls for: the design and implementation of reproductive health interventions which are specifically tailored to the needs of disabled people; an improvement in the poverty situation of disabled people; the provision of information, education and communication on reproductive health and HIV/AIDS; and awareness-raising in communities about the plight of disabled people in order to curb stigma and discrimination

The forgotten tribe : people with disabilities in Zimbabwe

CHORUMA, Tsitsi
January 2007

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This report discusses prevalence and causes of disability in Zimbabwe, and explores issues such as poverty, gender, health and HIV, education, employment and sports. It is based on a 2006 survey by Progressio Zimbabwe. The report concludes with a chapter on lessons learned and policy recommendations. This resource provides useful information for people interested in the situation and life of people with disabilities in Zimbabwe

The relationship between HIV and prevalence of disabilities in sub-Saharan Africa : systematic review

BANKS, Lena Morgon
et al
January 2015

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“This article systematically reviews the evidence on the prevalence and risk of disabilities among children and adults living with HIV in sub-Saharan Africa. The article concludes that HIV is widespread in sub-Saharan Africa and the evidence suggests that it is linked to disabilities, affecting a range of body structures and functions. More research is needed to better understand the implications of HIV-related disability for individuals and their families as well as those working in the fields of disability and HIV so that appropriate interventions can be developed”

Tropical Medicine & International Health

Too few to worry about? or too many to ignore?: the exclusion of people with disabilities from HIV programmes in India

MOLL, Kevan
2007

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This report looks at the findings of a research project to identify gaps in HIV awareness, prevention, care and support programmes in India and make recommendations on how HIV planning, policy and practice might be made inclusive of people with disabilities. In over 500 interviews with people with disabilities, levels of awareness of HIV and perceptions of vulnerability were explored as well as how these differ according to sex, age, impairment and location. In addition, organisations working on HIV were visited to look at whether people with disabilities were included in their programmes and organisations working with disabilities for their provision of information on HIV. The main recommendation of the report is that one or more disability NGOs become HIV champions to encourage and support the disability sector to engage with the HIV sector. The report offers a series of suggested strategies and some practical recommendations for both sectors. The project was funded by the Programme Management Office on behalf of the Department for International development

Videos

Keeping the promise : interventions by persons with disabilities against HIV/AIDS

HANDICAP INTERNATIONAL KENYA
2009

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People with disabilities, including people with disabilities who are living with HIV, are often excluded from their community and their family. This video presents testimonies of people with disabilities who are living with HIV and proposes actions in Kenya to fight against their exclusion. For example, it highlights support groups that have been created to educate people with disabilities, living with HIV or not, on sexuality, HIV/AIDS, and how to live positively with disabilities and reduce the stress caused by them. Another section of the video presents a support group for parents of children with disabilities where it is encouraged to talk about sexual abuse and violence on children and prevention of sexually transmitted diseases. Support groups for hearing and visually impaired people are also presented in the video. In addition to support groups, education and prevention are also promoted by through sport and street shows which contribute to the social inclusion of people with disabilities living with HIV

Protect yourself : an HIV and AIDS awareness video for use by deaf and hearing people

REMARK
2002

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This video provides HIV and AIDS awareness material for young deaf Ghanaians in Ghanaian sign language. The video aims to ensure that the deaf community in Ghana receives equal HIV and AIDS information as the hearing community in their own language. The film was made with a deaf film-making company from the UK working alongside young deaf people from a secondary school for the deaf

Youth to youth|Disability-sensitive youth to youth : methodologies in HIV and AIDS

HANDICAP INTERNATIONAL KENYA
2010

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This video features HIV and AIDS prevention and education initiatives in Kenya. It particularly targets the youth population due to a lack of available information and risk behaviours, such as sexuality, drug use and alcohol use. In order to prevent risks and present treatment options for the youth who are AIDS-carriers, several youth groups organized the following activities to prevent and fight the disease: street theatre for awareness-raising, group education sessions, and promotion of VCT services for communication and information. This video contains several testimonies and one features Mercy, a young girl who has AIDS after working as prostitute to feed her two children and is now involved in a support group