There’s little evidence of providing accessible HIV services to people with disabilities or integrating rehabilitation into HIV care despite the call of the UNAIDS Political Declaration on HIV and AIDS to include people with disabilities in the response to HIV.
This is according to the results of a recent study co-authored by a UKZN academics and published in The Lancet HIV journal.
Meanwhile, studies in Africa indicate that people with disabilities are at the same or increased risk of HIV while a significant number of people living with chronic HIV require services to mitigate the risk of disability over a lifetime.
The Lancet article, published just ahead of World Disability Day, was co-authored by UKZN Physiotherapist, Dr Verusia Chetty, Professor Jill Hanass-Hancock of the South African Medical Research Council,UKZN’s Health Economics and HIV/AIDS Research Division and a range of key thinkers and implementers in the field of disability and HIV.
While acknowledging the importance of highlighting the need of including people with disabilities in the Political Declaration on HIV and AIDS, the authors warn that ‘concrete actions are needed to ensure pledges do not become further political rhetoric’.
Said Chetty: ‘The new declaration urges governments and funding agencies to commit to ensure that the needs and human rights of people with disabilities are taken into account in the formulation of all responses to HIV and that HIV prevention, treatment, care and support programmes as well as sexual and reproductive health-care services and information are made accessible to persons with disabilities.’
According to the UNAIDS, ‘People with disabilities have equal or greater exposure to all known risk factors for HIV. This is due to the lack of appropriate access to HIV prevention, information and services and the high rate of sexual and gender-based violence against persons with disabilities of all ages. A mix of factors contribute to the vulnerability of young people with disabilities to HIV infection: poverty and discrimination, lack of accessible information on HIV-prevention and exclusion from education and health services, which may increase HIV-risk-taking behaviour, such as unprotected sex.’
Hanass-Hancock, who called for conscious efforts and commitment to include people with disabilities in a recent strategic meeting with international agencies such as UNAIDS, WHO, USAID, UNFPA, civil society and funding agencies during the recent International AIDS Conference 2016 highlighted, ‘We have now evidence from over a decade of research on the relationship of disability and HIV, the exclusion of people with disabilities has finally been acknowledged and a strong statement has been included in the new political declaration. However, this political statement has to be translated into actions by government, funder, researchers and civil society.’
‘One of the core problems is the continued negligence of disability in mainstream research, surveillance and implementation interventions. As a result most mainstream HIV research does not collect data on disability and is therefore “blind” for the needs of a very vulnerable group. We know from small scale studies that people with disabilities lack access to health services, including HIV prevention (sexuality education or HIV testing) and treatment (rehabilitation). We also know that these barriers can be overcome as we have developed promising methods to enhance inclusion, accessibility and comprehensive care. More research is needed to further evaluate or scale up these promising interventions,’ said Hanass-Hancock.
In order to improve inclusion and integration, the authors call for focused policy and programme actions such as international agencies to promote inclusive strategies and disability data gathering; funding agencies to include a compulsory section on disability inclusion similar to gender, and civil society to advocate for disability inclusion in national strategic plans and programmes as well as using clear indicators and scientists to include disability data in mainstream research and surveillance.