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The sexual and reproductive rights of women and girls with disabilities

FROHMADER, Carolyn
ORTOLEVA, Stephanie
July 2013

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"This Briefing Paper examines the sexual and reproductive rights of women and girls with disabilities in the context of the future development agenda Beyond 2014 and Post 2015"
Issues Paper
ICPD Human Rights Conference on Sexual and Reproductive Health The Hague, Netherlands
7-11 July 2013

Disabling sexualities: Exploring the impact of the intersection of HIV, disability and gender on the sexualities of women in Zambia

WICKENDEN, Anna
NIXON, Stephanie
YOSHIDA, Karen K
2013

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Background: Women with a disability are often characterised as a homogenous social group consigned to a cultural stereotype with assumptions of dependence, asexuality and gender neutrality. Furthermore, there is a void of research about the experience of people with disabilities following diagnosis with HIV. Little is known about how HIV diagnosis intersects with disability and gender and how it shapes the experiences of intimacy and gender roles of those negotiating this intersection.

 

Objective: The objective of this study was to explore how HIV, disability and gender shape the perspectives of HIV-positive women with disabilities regarding intimacy and gender roles.

 

Methods: Twelve women in Lusaka, Zambia were recruited for in-depth semi-structured interviews to explore their experiences of having a disability and living with HIV. Interviews were conducted in English, Bemba, Nyanja and Zambian sign language. Descriptive and thematic analyses were conducted, followed by in-depth gender analyses of data relating to intimacy and gender roles.

 

Results: Data analysis led to the identification of two main themes: the impact of HIV diagnosis on intimate relationships amongst the participants; and the disruption and renegotiation of gender roles. These findings demonstrate the loss of intimacy (often decided by the participants) and changes in women’s gender roles (infrequently decided by them).

 

Conclusions: The narrow approaches to sexuality and HIV that reinforce misconceptions and stereotypes need to change. In their place should be inclusive and disability and sex-positive approaches that are informed by the diverse realities of women’s lives. Further research is needed to develop stronger evidence of the impact of HIV and disability on gender roles and sexuality.

Exploring Knowledge and Attitudes towards HIV/AIDS among Deaf People in Ghana

MPRAH, W K
2013

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Purpose: By exploring the level of knowledge about HIV/AIDS and attitudes towards persons with HIV/AIDS among deaf people in Ghana, this article aims to identify and correct possible gaps in awareness.

 

Method: A participatory sexual and reproductive health (SRH) needs assessment was conducted, targetting deaf people who were fluent in the Ghanaian Sign Language (GSL). The study design was a two-phase, sequential, mixed methods approach. Three focus groups assisted in the development of a survey, which was then implemented for needs assessment data collection. The 179 study participants consisted of 26 focus group participants, 152 survey respondents and 1 key informant. Of the focus group participants, 7 were executives of Ghana National Association of the Deaf (GNAD), 10 were adult males, and nine were adult females. Apart from the key informant, all the participants were deaf persons.

 

Results: The study indicated that many respondents still had misconceptions about HIV/AIDS and had difficulty identifying preventive methods, but their attitudes towards persons with HIV/AIDS was generally positive.

 

Conclusion: More attention needs to be paid to the requirements of the deaf community and to designing HIV/AIDS programmes and services that are deaf-friendly and accessible.

Strengthening communities to integrate persons with disabilities in the HIV and AIDS response in Rwanda

DELEU, Marijke
May 2013

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"This document aims to capture some of the key lessons learned from Handicap International’s New Partnership Initiative project in Rwanda, which started in 2008 with the objective to integrate persons with disabilities in HIV and Sexual Violence (SV) prevention efforts and service provision generally. It is the result of qualitative, multi-stakeholder study about how change occurred within the project and how the experience could be modelled for adaptation or replication in Rwanda or other contexts"
SD/LL 08

A deeper silence : the unheard experiences of women with disabilities : sexual and reproductive health and violence against women in Kiribati, Solomon Islands and Tonga

SPRATT, Joanna
March 2013

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"This report contains information gained in situation analyses exploring the SRH needs of women with disabilities in three Pacific Island countries: Kiribati, Solomon Islands and Tonga. This work was carried out over a four-month period spread out between October 2010 and September 2011. UNFPA undertook these situation analyses to gain greater understanding of the opportunities and needs experiencedby women with disabilities in relation to their ability to realize their sexual and reproductive rights"

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 : 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 

Achieving gender equality and women’s empowerment in the post-2015 framework

SMEE, Sharon
WOODROFFE, Jessica
January 2013

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"To achieve real and sustainable change, the post- 2015 framework must focus on the social transformations required to eradicate poverty and empower the most marginalised and excluded people. This report argues that such transformation cannot happen without tackling the underlying causes of gender inequality which, in turn, will not be successful without the political will and resources that a standalone goal on gender equality can provide"

Why do women not use antenatal services in low- and middle-Income countries? a meta-synthesis of qualitative studies

FINLAYSON, Kenneth
DOWNE, Soo
January 2013

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This article aims to inform the development of future antenatal care programmes through a synthesis of findings in all relevant qualitative studies. The findings suggest that there may be a misalignment between current antenatal care provision and the social and cultural context of some women in low and middle income countries
PLoS Med, Vol 10, Issue 1

HIV issues and people with disabilities: A review and agenda for research

GROCE, Nora
et al
January 2013

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The AIDS and Disability Partners Forum at the UN General Assembly High Level Meetings on AIDS in New York in June 2011 and the International AIDS Conference in Washington, DC in July 2012 underscore the attention to the impact of HIV and AIDS on persons with disabilities. However, research on AIDS and disability, particularly a solid evidence base upon which to build policy and programming remains thin, scattered and difficult to access. In this review paper, we summarise what is known about the intersection between HIV and AIDS and disability, paying particular attention to the small but emerging body of epidemiology data on the prevalence of HIV for people with disabilities, as well as the increasing understanding of HIV risk factors for people with disabilities. We find that the number of papers in the peer-reviewed literature remains distressingly small. Over the past 20 years an average of 5 articles on some aspect of disability and HIV and AIDS were published annually in the peer-reviewed literature from 1990 to 2000, increasing slightly to an average of 6 per year from 2000 to 2010. Given the vast amount of research around HIV and AIDS and the thousands of articles on the subject published in the peer-reviewed literature annually, the continuing lack of attention to HIV and AIDS among this at risk population, now estimated to make up 15% of the world's population, is striking. However, the statistics, while too limited at this point to make definitive conclusions, increasingly suggest at least an equal HIV prevalence rate for people with disabilities as for their non-disabled peers.

Sexual Health of Women with Spinal Cord Injury in Bangladesh

LUBBERS, N P M
NURI, R P
VAN BRAKEL, W H
CORNIELJE, H
2012

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Purpose: To identify factors influencing the sexual health of women with spinal cord injury (SCI) in Bangladesh.

 

Methods: This study used both qualitative and quantitative methods. The quantitative part used a case-control design. Cases were women with SCI and controls were age-matched women without SCI. Questionnaires were used to collect data concerning the sexual health status of women. Multivariate logistic regression was done to determine which factors had an independent effect on sexual health. In-depth interviews were held with a sub-group of women from both groups, and interview guides were used. The in-depth interview data was subjected to content analysis.

 

Results: In total, 92 questionnaires were given out and 30 in-depth interviews were conducted. A relationship was found between physical factors and sexual health, as pain, vaginal dryness and physical discomfort were mentioned more frequently among women with SCI. Environmental and emotional factors such as stigma, satisfaction of the husband and support from the husband and friends had an influence on the sexual health of the women with SCI, as well as the other group of women.

 

Conclusions: From interviews it became clear that most of the women with SCI were dissatisfied with their sexual health as compared to the women without SCI. However, environmental and emotional factors such as attitudes, support and stigma, rather than physical factors, were the most important influences on sexual health in both groups of women.

Sterilisation and intellectually disabled people in New Zealand—still on the agenda?

HAMILTON, C
2012

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Support through care and protection within a medical framework, rather than through the idea of independence within the least restrictive environment, continues to guide service provision for intellectually disabled people in the sexuality area. Past practices have included use of involuntary sterilisation. This article outlines the outcome of a search for information undertaken because of concerns that use of sterilisation-related procedures may remain embedded in contemporary approaches to sexuality support management. Verified instances of hysterectomy carried out between 1991 and 2001 were uncovered. Documents tabled at a Parliamentary Select Committee in 2003 expressing concerns about use in relation to young disabled girls were also found. Requests for sterilisation-related procedures exemplify how the right of all vulnerable citizens to full bodily integrity is currently adjudicated in New Zealand. It is suggested that further research is needed to pinpoint and address the underlying social customs through which requests for such procedures are negotiated and resolved.

Forgotten sisters : a report on violence against women with disabilities|An overview of its nature, scope, causes and consequences

ORTOLEVA, Stephanie
LEWIS, Hope
August 2012

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This report focuses upon prevalence and pervasiveness of violence against women and girls with disabilities. It "reviews available information on the forms, causes and consequences of violence against women when both gender and disability collide to exacerbate that violence; examines the impact of the multiple and intersecting dimensions of women’s lives and; their impact on violence against women with disabilities. The Report outlines the international and regional legal framework, highlighting relevant provisions and interpretations. Finally, the Report examines the extent to which States have met their due diligence obligations (setting forth a few country-specific case studies) highlights some best practices, discusses significant gaps in the research and makes recommendations for future action"
Paper series no 104-2012

United States strategy to prevent and respond to gender-based violence globally

US AGENCY FOR INTERNATIONAL DEVELOPMENT (USAID)
August 2012

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This report outlines a strategy "to prevent and respond more effectively to gender-based violence globally. The purpose of the strategy is to establish a government-wide approach that identifies, coordinates, integrates, and leverages current efforts and resources. The strategy provides Federal agencies with a set of concrete goals and actions to be implemented and monitored over the course of the next three years with an evaluation of progress midway through this period. At the end of the three-year timeframe, the agencies will evaluate the progress made and chart a course forward"

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

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

Moving forward and gaining ground: the sterilisation of women and girls with disabilities in Australia

FROHMADER, Carolyn
June 2012

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This paper addresses the issue of forced sterilisation and reproductive right of women and girls with disability in Australia. "It discusses some of the critical issues in the consideration of forced sterilisation as a human rights issue, and looks at some of the key strategies WWDA has employed to advance our efforts to promote the sexual and reproductive rights of disabled women and girls, on an equal basis with other women and girls"
Available in pdf, word, large print text only and powerpoint presentation formats

Inclusive and integrated HIV and AIDS programming

MAC-SEING, Muriel
March 2012

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"This policy brief is an introduction to Handicap International’s 2012 Policy Paper "Inclusive and integrated HIV and AIDS programming". Handicap International promotes an inclusive approach to improving quality of life and access to services for persons with disabilities. This means that basic health care and socioeconomic services are developed according to the principle of Universal Access, where all people with impairments (whether physical, sensory, intellectual or mental), have equal access and opportunities for participation. This inclusive approach also ensures that gender considerations and disparities are acknowledged as a cross-cutting issue"
Policy brief No 7

Infertility : why can’t we classify this inability as disability?

KHETARPAL, Abha
SINGH, Satendra
2012

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"Disability is a complex phenomenon. It reflects an interaction between features of a person's body and features of the society in which he or she lives. International Classification of Functioning, Disability and Health (ICF), lays stress on the functional as well as the structural problem of a person. All the definitions of disability also include the disorders of the reproductive and endocrine system. So infertility and impotency should also be included in the category of disability. It affects the participation in areas of life and can have a disabling affect on an individual"
Australian Medical Journal, Vol 5, No 6

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