People with disabilities and experiences with HIV

The response to HIV and AIDS can largely be characterized as the identification and targeting of key populations that are believed to be at increased risk of exposure to HIV. These populations of people are now well known, including, depending on region and epidemic, migrant workers, sex workers, men who have sex with men, injecting drug users, and indigenous people. Even in generalized epidemics, as seen in southern Africa, prevention and care efforts have focused, in part, on those perceived to be most at risk, such as youth in resource-poor settings.

People with disabilities have for a long time been excluded from any discussion of key populations at increased risk for HIV. However, the logic underpinning this exclusion has been flawed and in their recent policy brief UNAIDS acknowledges people with disabilities as a key population at higher risk of exposure to HIV [21].

Myths about people with disabilities are debunked

First, the assumption that people with disabilities comprise only a small minority is incorrect. The World Health Organization estimates that one in 10 people in the world lives with some sort of disability [22]. However, this 10% is not distributed evenly around the world; as is the pattern with many challenges, the prevalence of disabilities in resource-limited settings outweighs that of more wealthy countries.

As such, one can assume that more than 10% of the population has a disability in places like southern Africa, where HIV prevalence is also at its highest.

Second, the abiding assumption that people with disabilities are at little or no risk for HIV was disproved in the Global Survey on HIV/AIDS and Disability, a seminal World Bank study conducted by Nora Groce in 2004 [23]. Data collected from organizations working with people with disabilities in 57 countries across four continents concluded that almost all known risk factors for HIV and AIDS are increased for people with disabilities [24]. The eight areas of vulnerability identified in the survey continue to be proven through additional empirical research.

The following section highlights evidence supporting our understanding of why people with disabilities are at increased risk for HIV.

1. Poverty: People with disabilities are often the poorest members of their communities, and the World Bank estimates that persons with disabilities may account for 20% of the poorest citizens in the world [23-25].

2. Lack of education: People with disabilities are typically excluded from school because they are not considered in need of education, are assumed to be a distraction in class, or are believed to be incapable of learning [23, 26]. Even when in school, children with disabilities are less likely to receive science and health education and more likely to be excused from sex education courses [24, 27-29].