People with physical, sensorial and intellectual impairments are among the most vulnerable to the impact of HIV and AIDS.
HIV is a significant problem amongst disabled people worldwide that is rarely recognised. According to the Global Survey on HIV/AIDS and Disability(1), individuals with disabilities are at equal or higher risk of HIV infection, compared to people without disabilities.
There are many reasons for the increased risk. Because they are less likely to marry, people with disabilities are more likely to have several sexual partners in a series of unstable relationships(2). They are also far more likely to be victims of sexual abuse and rape. In cultures where people believe they can be “cleansed” of the HIV virus by having sex with virgins, people with disabilities become targets for abuse as they are assumed not to be sexually active(3). Physical dependence, life in institutions, and “the almost universal belief that disabled people cannot be a reliable witness on their own behalf”, also make them particularly vulnerable to sexual abuse and infection from HIV(4).
© S. Bonnet / Handicap International
Lack of information and services
Low literacy rates among people with disabilities and the difficulty of accessing radio and television messages for deaf and blind people present real challenges to information outreach. Sex education programs for disabled people are rare. Access to general healthcare services is also poor for a variety of reasons, including social and economic obstacles and problems with the physical accessibility of health facilities. Disabled people living with HIV in Africa often face multiple discrimination as a result of being disabled, poor and HIV-positive.
Handicap International’s approach to communities affected by HIV and AIDS
Handicap International sets up community development projects to promote inclusion of people living with the virus. Our approach relies on the involvement of people living with HIV and has four components: prevention, healthcare, social and economic inclusion, and rights & policy. We work with local organisations and networks to ensure that change is sustainable over the long term, by reducing discrimination in communities, schools, the health system and the workplace, as well as providing opportunities for inclusion.
Handicap International has a strong history of community-based healthcare programmes. By training healthcare providers, establishing community pharmacies and supporting home-based care initiatives, we seek to empower local people to improve their own healthcare at community level, while lobbying and promoting change at higher levels of government.
Sources
(1) Groce N. Global Survey on HIV/AIDS and Disability. The World Bank/Yale University, April 2004. http://globalsurvey.med.yale.edu
(2) Economic and Social Commission for Asia and the Pacific. Hidden sisters: women and girls with disabilities in the Asian Pacific region. New York: United Nations, 1995.
(3) Jewkes R, Martin L, Loveday P. The virgin cleansing myth: cases of child rape are not exotic. Lancet 2002; 359: 711.
(4) Nosek MA, Howland CA, Hughes RB. The investigation of abuse and women with disabilities: going beyond assumptions. Violence Against Women 2001; 7:477-99.
