Gaps in the global HIV response leave people with disabilities at high risk of infection
A study has found higher HIV prevalence and increased risk among people with disabilities - a group often excluded from HIV programming because of perceptions that they are not sexually active so not at risk.
A recent study has found that people with disabilities in developing countries are at high risk of HIV infection. The HandiVIH study – the first to compare HIV prevalence and other risk factors in people with and without disabilities – found the prevalence of HIV among people with disabilities to be nearly double that than among those without (at 6.8% and 3.9% respectively).
The study found that people with disabilities were more likely to experience factors which put them at higher risk of HIV infection. These include lack of education, poverty, difficulty accessing health information and services, sexual violence, substance abuse and stigma and discrimination. Beyond the higher likelihood of experiencing these risk factors, there was a higher HIV prevalence for people with disabilities compared with control groups of people who experienced the same risk factors but were not living with a disability.
The HandiVIH study was carried out in Cameroon. However, similar factors linking HIV risk and people living with disabilities are prevalent across developing countries. People with disabilities are often excluded from HIV programming because of perceptions that they are not sexually active so not at risk. In the HandiVIH study, 80% of participants with disabilities were sexually active – contradicting this preconception – and, overall, they also had less knowledge of HIV than people without disabilities.
UNAIDS published its strategy for integrating disability into AIDS programmes in 2012. This strategy advocates for the inclusion of people with disabilities in HIV services.
“Universal access means that no one is excluded from the lifesaving circle of protection that HIV prevention, treatment, care and support provides,” explains Michel Sidibé, the Executive Director of UNAIDS.
“But too often people with disabilities find themselves on the outside of the circle – invisible and ignored.”
Countries such as South Africa and Uganda may offer a model for disability-inclusive HIV programming. Both of these countries have included people with disabilities in their national strategic plans and have made progress establishing disability-friendly programmes and services. More rigorous research is needed in these countries and more widely in order to inform effective policy and programming.
Around a billion people - 15% of the world’s population - live with a disability. The majority are in low-income and middle-income countries. Creating disability-inclusive HIV programming is considered an essential factor in achieving the UNAIDS target of eliminating HIV by 2030.