Africa: Disabled People 'at Significantly Increased Risk' of HIV Infection

Washington, DC — Major gaps in national HIV/Aids prevention campaigns and treatment programs have made disabled people more vulnerable to HIV infection than their non-disabled counterparts, researchers for the World Bank/Yale University Global Survey on HIV/Aids and Disability reported Monday in a presentation of their preliminary findings for World Aids Day.

"Disabled people are at risk, and often at a significantly increased risk for becoming HIV positive, and once they become HIV positive, are much less likely to get services," said Dr. Nora Groce, Associate Professor at the Yale School of Public Health. "In many ways, what we are discussing is a human rights issue."

Groce and her team at Yale searched for literature on HIV and disability. After finding little research on the subject, they constructed an informal survey, which was distributed to more than 80 organizations working on HIV or disability, she said.

"A non-scientific description of it was a fishing expedition," Groce said. "We just wanted to see what was out there."

Of the 2,800 surveys mailed or e-mailed last July, 425 surveys were returned as of November 15, Groce said. Some 43 percent of respondents were living and working in Sub-Saharan Africa, she said.

Researchers found common themes throughout the world, Groce said.

Health professionals often assume that disabled patients are not sexually active and are less likely to be targets of sexual violence. Groce interviewed one deaf man in Swaziland who told her he had been turned away from getting an HIV test at the local health clinic because the nurse told him deaf people are not at risk for HIV.

"I said, 'Can I ask you a personal question? How many sexual partners have you had in the last year?'" Groce said. "He said, 'I get around. I've had five.' I said, 'Are you concerned?' He said, 'I'm scared to death.'"

Disabled people are up to three times more likely to be victims of physical abuse, sexual abuse or rape as members of the general population, Groce said, as they are often perceived as easy targets for violence by would-be perpetrators.

Th idea that sex with a virgin can cure Aids has also fueled some violence, according to Groce. Because disabled women are often assumed to be asexual and therefore virgins, many are "systematically raped by people who are desperate to get rid of their infection," she said.

Disabled people are less able to defend themselves from attack and find it more difficult to seek recourse through the courts, which are often physically inaccessible or do not have sign language interpreters available, Groce said.

Even though disabled people confront risk factors for HIV at rates "equal to or up to three times higher than the general public," Groce said, national education campaigns and treatment programs have failed to meet their needs.

"The question is why they're not being reached," Groce said. "There are often inaccessible formats. You'll have national radio campaigns which are inaccessible to the deaf."

Building a wheelchair ramp for health clinics or holding an HIV educational lecture on the first floor of a building instead of the second floor are low-cost ways to educate disabled people along with the general public, Groce said.

Judith Heumann, World Bank Advisor on Disability and Development, said that the survey's findings require more cooperation between agencies and a more holistic approach towards HIV and disability.

"We need to be putting a disability lens on all the projects at the World Bank and external to the Bank," Heumann said.

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