To achieve global commitments to halt and begin to reverse the spread of HIV and AIDS among children, and keep with the rights-based approach, UNICEF’s programming and advocacy on HIV and AIDS should take account of all vulnerable children, adolescents and women, including those with disabilities.
People with disabilities have equal or greater exposure to all known risk factors for HIV (UNFPA, 2008). 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, as well as lack of accessible information on protection as well as services, which in turn results in risk-taking behaviour, such as unprotected sex.
Mothers with disabilities are at equal or increased risk of being HIV positive. Key ‘risk factors’ for HIV including for example a lack of education, social marginalization, etc. are higher for both men and women with disabilities and ‘risk factors’ for disability (e.g. poverty, lack of education, social marginalization, etc.) further compound the risk of becoming HIV positive (Groce and Trani, 2004). Recent research does confirm that women with disabilities are an essential group for achieving the eradication of mother-to-child transmission.
In the area of prevention, to make programmes inclusive and ensure they reach people with disabilities as direct clients and as service providers, UNICEF considers the following strategies:
Involve the target audience:
Include adolescents and women with disabilities in HIV and AIDS training groups so they can get involved in prevention and outreach initiatives themselves;
Train educators, outreach workers, clinical and social services staff on disability;
Ensure prevention programmes reach people with disabilities, for example HIV and life skills programming targeting young people should incorporate the specific concerns of young people with disabilities in school and those that aren’t;
Identify local disability organisations and involve them in all phases of prevention efforts;
Focus on accessibility:
Ensure measures to improve accessibility of health services to adolescents is inclusive of adolescents with disabilities. Such measures must also safeguard the privacy of the clients, during communication of sensitive information;
Ensure all public education materials and initiatives are accessible to and inclusive of children and adults with different disabilities, by involving them directly in the selection of content and format (e.g. sign language, braille, digital or audio versions, simple language, simplified graphic information, etc.), testing and adaptation of materials. In awareness-raising campaigns involving the media, it is important that images reflect the target population for the messages and should therefore not be exclusive of people with disabilities;
Ensure attention to disability in efforts to improve and scale up care and support services to children affected by HIV and AIDS. National HIV and AIDS plans and other development instruments provide an opportunity to promote responses that take into account the diverse needs of different groups of children living in communities affected by HIV and AIDS, including those with disabilities.
Promoting sexual and reproductive health for persons with disabilities - Guidance Note Geneva, World Health Organization - Overview of sexual and reproductive health for persons with disabilities, including overview of how AIDS links to broader sexual and reproductive health concerns for adolescents and adults with disabilities, WHO/UNFPA, 2009.
Disability and HIV policy brief - Policy brief providing a concise and excellent overview of issues around HIV/AIDS and they effect the disability community globally, WHO, OHCHR and UN AIDS, 2004.
Disability and HIV/AIDS at a Glance - Overview of disability and HIV/AIDS – while the report is about 8 years old, it is still useful in raising a number of issues related to disability and HIV/AIDS is a succinct manner – and the accompanying ‘Disability and AIDS at a Glance’ may be particularly useful in providing a quick overview of key issues involved, World Bank, 2004.
The deaf peers' education manual : a training manual - developed by the Kenyan Peer Education Network. Training manual on AIDS with particular reference to the needs and concerns of the Deaf community. While not specifically for Deaf children and adolescent, information in this well done manual, provides a good starting place for reaching this community, Sahaya International, 2007.
Guidelines for Inclusion of Persons with Disabilities in HIV/AIDS efforts - Recommendations on how to include persons with disabilities in both general as well as in disability-specific HIV/AIDS interventions. Groce N, Trasi R, Yousafzai A, 2010. Also available in French, Spanish, Portuguese & French.